4.1. Features of follow up and care for postoperative patients
Postoperative period - the period from the moment of surgery completion until till the patient's recovery or certain outcome of treatment, during which the following objectives are being solved: improvement of the patient's state; stimulation of regeneration; prevention, revealing and treatment of occurring complications; rehabilitation. There are 3 stages of the postoperative period: early (3-5 days); late (2-3 weeks); long-term - rehabilitation period (from 3 weeks to 2-3 months).
Intensive care in early postsurgery period without complications includes (by indications): cessation of pain syndrome; correction of the functions of cardiovascular, respiratory, urinary systems, fluid and electrolyte balance; prevention of thromboembolic complications; detoxication therapy; nutritional support of the patient; bandage and drainage control.
The patient's position in the bed is determined by the character of performed surgery:
► dorsal position (the most frequent). During the first 2 hours after anaesthesia, the patient lies in bed without a pillow, with their head turned to the side which reduces the risk of aspiration of vomit masses;
► Fowler's position (with a raised head of the bed) is used mainly after surgeries in the gastrointestinal tract; it provides high-quality drainage of the abdominal cavity due to the possibility of its removal from the lower parts by draining tubes;
► Clark's position (with a raised feet of the bed) is used at shock, profuse blood loss in order to prevent brain anaemia;
► Simms position (prone position) is used after brain or spine surgeries.
The patient is covered in bed, heating pad filled with hot water (but not boiling one) is applied to the feet by indications, the stopper is tightly screwed, checked for leaks and covered with a towel.