Postoperative Instructions for Patients after Shoulder Arthroscopies ("keyhole surgery")

WOUND:

After arthroscopy the wound is covered with “opsite” dressing. These should generally be left in place for 10 days. Due to the large amount of fluid used during the arthroscopy, it is normal to see some bloody drainage on the dressings. If bright red blood persists despite elevation and icing, please call the hospital.

Do not remove or cut any visible suture, paper strips over the incision. Wounds should be kept dry for 10 days unless otherwise instructed. After the post-op day 10, the wound may be exposed in the shower without scrubbing the area. The wound should not be submerged in a bathtub or pool until three weeks postoperatively.

Icing is very important for the first 5-7 days postoperative.

SLEEPING:

Patients are generally more comfortable sleeping in a reclining chair or with pillows propped behind the shoulder. Some difficulty with sleeping is common for 2-3 weeks after surgery.

ICING:

while the dressing is in place, icing should be continuous. Once the dressing is removed on the first or second day, ice is applied for 20-minute periods 3-4 times per day. Care must be taken with icing to avoid frostbite to the skin.

EXERCISE ADVICE FOR PATIENTS:

On the first post-op day, begin doing the physio therapy exercises that were given/instructed to you. You may use your arm to assist with dressing, eating and personal hygiene unless specifically instructed not to. Be sure to use and move your hand, wrist, and elbow in order to decrease swelling in your arm. While exercise is important, don't over-do it. Common sense is the rule.

NAUSEA/VOMITING:

The anaesthetic drugs used during your surgery may cause nausea for the first 24 hours. If nausea is encountered, drink only clear liquids. The only solids should be dry crackers or toast. If nausea and vomiting become severe or the patient shows sign of dehydration (lack of urination) please call the hospital.

HIGH TEMEPRATURE:

A low-grade fever (100.5) is not uncommon in the first 24 hours but unusual beyond. Please call the hospital with any temperature over 101.0 degrees. Patients may take aspirin (75 mg a day) until your sutures are removed. This may lower the risk of a blood clot developing after surgery. Should severe calf pain occur or significant swelling of calf and ankle, please call the hospital.

PAIN MANAGEMENT:

Local anesthetics (i.e. Marcaine) are put into the joint during surgery. It is not uncommon for patients to encounter more pain on the first or second day after surgery.

This is the time when swelling peaks. Using the pain medication as directed will help control pain with little risk of complication. Taking pain medication before bedtime will assist in sleeping. It is important not to drink alcohol or drive while taking narcotic medication. If the patient was prescribed narcotic medication (i.e. Tramadol, Co-dydramol) the patient can supplement those medications with 200 mg or 400 mg of Ibuprofen every 4-6 hours. The patient should resume their normal medications for other conditions the day after surgery. We have no specific diet restrictions after surgery but extensive use of narcotics can lead to constipation. High fibre diet, lots of fluids, and muscle activity can prevent this occurrence.

SPLINT:

Following shoulder surgery, it is common to use a sling (“collar ‘n’ cuff”) for 3-5 days after surgery. In some cases a different sling (Polysling) is needed or remaining in the sling for even much longer. Patient will also be instructed on gentle range of motion exercises to be started. Bruising down to the elbow and chest wall is not uncommon.