If your baby has anal surgery without a stoma, he or she will go home in one to three days. Your baby will most likely have a lot of diarrhea, and it will be important to protect the skin around the anus at all times. Your child's nurse will teach you how to mix and apply a cream called "butt balm". Use this cream at all times to protect the skin from the irritating effects of diarrhea.
If your baby has a stoma, he or she may stay in the hospital longer. The temporary stoma will remain in place for several months, and during that time stool will drain into a pouch worn on the outside of the body. Your child's nurse will teach you how to take care of the stoma.
- Pain Management
- Care for Dressings
- Healing Ridge
- Bathing Restrictions
- Stoma Care
- Skin Care
- Activity Restrictions
- Do I see the surgeon again after the operation?
- Why does my child need anal dilators?
- When do I call the surgeon's office?
- Parent Support Organizations
Pain Management
Prescription pain medication (narcotics) is not usually needed once your child is home. Most children only need Acetaminophen (Tylenol®) or Ibuprophen (Motrin®). Give the medication according to the dosage directions on the label. If your child is still uncomfortable, call our office and we may prescribe something stronger.
Care for Dressings
If your baby has an incision on the abdomen there will be a gauze pad and clear plastic dressing in place, this dressing is to be removed 2 days after the operation. Under this dressing will be pieces of tape called Steri-strips®. On the Steri-strips®, there may be a small amount of blood. This is normal. Your child can bathe with the Steri-strips® in place. These can be pulled off one week after the operation. The skin around the incision may be red and bruised and slightly swollen. This can last several weeks. There will be no visible stitches to remove because they are under the skin. The stitches will dissolve after several weeks. Sometimes these stitches are irritating and will come out of the skin, through the incision. If this happens the incision will look red and may drain white, yellow or red fluid. This can be normal for some children and will get better with time and daily bathing.
If your child has an incision, the wound is closed with dissolvable suture (stitches). These stitches are under the skin and do not have to be removed. In some children these stitches may come through the incision about 4 weeks postoperatively. This may be associated with a little local redness and pus and it may involve an end of the incision or a larger portion. This is normal and is best treated by gently cleansing the area with soap and water and waiting. When the suture falls out or completely dissolves, the wound will heal. If your child has worsening redness, swelling pain of the incision and a fever within 2weeks of the operation, please call our office.
Healing Ridge
If your child has an abdominal incision, you will feel a firm ridge just under the incision once it is healed. This is called a healing ridge and it is normal to find after surgery. The healing ridge lasts for several months before it softens and disappears.
Bathing Restrictions
Your child may bathe (or shower) as soon as two days after surgery. Once your child is feeling better, before discharge or at home, he or she may bathe (or shower). Bathing is a good way to clean and soothe the anal area. and gently clean the skin without injury. Some parents prefer to use a hair dryer, on the low (cool) setting, to dry the anal area well before putting on more protective cream. If your child has a stoma, the pouch can be removed and your child and his or her stoma can be in a the bath. This will not harm the stoma and is recommended.
Stoma Care
The pediatric surgery nurse specialist and bedside nurse will teach you to care for your child's stoma.
Skin Care
Continuously apply the recommended protective skin care products. Begin as early as the day of surgery. Do not stop using the skin protective products until the number of bowel movements becomes less, usually after many weeks. If your child develops a rash that does not get better, please call our office.
Butt Balm Recipe
The recipe for butt balm is: a four ounce tube of Desitin® ointment, a one ounce bottle of Stomahesive® powder and a 1/2 ounce bottle of Mycostatin® powder combined to create a cream the consistency of peanut butter. The surgical nurse will order the prescription powders needed to mix the balm. Please give us the phone number of your pharmacy once you go home.
Activity Restrictions
Your child can return to doing his or her usual activities without any special restrictions, unless the pediatric surgeon tells you otherwise. If your child is school age, school activities can begin again as soon as he or she feels well enough. If you need a letter sent to your child's school about the operation and recovery, please call our office. If your child has a stoma, supplies will be ordered for your baby. You will be taught how to take care of the stoma and use the supplies before going home.
Do I see the surgeon again after the operation?
If your child has a stoma, you will need to make an appointment to be seen one month after discharge. If your child has a primary surgery or stoma closure, he or she will need to be seen in the Pediatric Surgery office two weeks after the operation. At this visit, his or her anus will be checked to make sure the opening is large enough for stool to pass easily. Sometimes a child's anus has to be dilated, or stretched, for several weeks or months following surgery. If this is necessary, your child's surgeon or surgical nurse will teach you how to do dilations at home.
Why does my child need anal dilators?
You will receive a set of anal dilators before you leave the hospital. Bring these to your first surgical appointment. Some anal incisions heal by contracting and becoming tight. If this happens, passing bowel movements will be very difficult. Stretching the anal incision gently with anal dilators may be recommended by your child's pediatric surgeon. If your child's pediatric surgeon recommends the use of dilators at your first appointment, you will need to follow their instructions carefully.This is essential to prevent stricture. If you are having problems with anal dilation contact the surgical nurse practitioner.
When do I call the surgeon's office?
Call our office at 415-476-2538 for the following:
- Any concerns you have about your child's recovery
- A temperature of 101°F or higher
- A red incision
- Increasing pain and tenderness at the incision
- Any liquid coming out of the incision
- A change in the number of bowel movements each day
- No bowel movement for one day
- Foul smelling bowel movements
- Abdominal distention
- Vomiting
- Red rash around the anus that is not getting better
- Any questions concerning your child's stoma
Parent Support Organizations
Pull-Thru Network Inc.
http://www.pullthrough.org
(206) 978-2930
Bonnie McElroy, Executive Director
2312 Savoy St.
Hoover, Alabama 32226-1528