After the operation, children can go home once they are feeding normally, having bowel movements, are comfortable on pain medication by mouth and do not have a fever.
Babies who have this operation, without a stoma, often have very frequent bowel movements that can cause severe diaper rash. We will begin using a protective skin cream as soon as bowel movements start. This cream is to be applied after each bowel movement and with each diaper change. Use thickly to protect the skin from the irritating effects of the stool. We recommend you continue this cream at home, for several weeks, until the number of stools passed each day become less frequent.
Newborns that have a stoma made will need a special bag placed on the abdomen, over the stoma, to catch the stool. Your baby's nurses will explain how the bags are applied and removed. The surgical nurse practitioner will order stoma bags for your child to be sent to your home after hospital discharge. You will use the bags at home until the stoma is closed.
- Pain Management
- Care for Dressings
- Healing Ridge
- Bathing Restrictions
- 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 is not routinely required after hospital discharge. Most children are comfortable using Acetaminophen (Tylenol®) or Ibuprophen (Motrin®) once they are at home. Follow 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 child had an incision there will be pieces of white tape called Steri-strips® over the incision. On the Steri-strips®, there may be a small amount of blood. This is normal. There may or may not be a gauze and clear plastic dressing over the Steri-strips®. The gauze, if present, can be removed two days after surgery. Your child can bathe after the gauze is off, with the Steri-strips® in place. These strips fall off on their own or can be removed one week after the operation. The skin surrounding the incision(s) may be red and bruised, and the incision may be slightly swollen. This can last many days. There will be no visible stitches to remove because they are under the skin. The stitches will dissolve after several weeks. If your child's wound is left open by the surgeon because of an infection, it must be dressed in a special way. You will be instructed on how to care for the wound before leaving the hospital.
In most operations, 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
After the incisions are healed you will be able to feel a firm ridge just underneath the cut. This is called a healing ridge and it is normal to find this under an incision after an operation. The healing ridge usually lasts for several months before it softens and disappears.
Bathing Restrictions
Your child may bathe or shower as soon as two days after the operation or once he or she is feeling better. Bathing may be done without restriction. If your child has a stoma, the pouch can be removed and your child, and his or her stoma, can be immersed in the bath. This will not harm the stoma and is recommended.
Activity Restrictions
There are no specific activity restrictions following surgery.
Do I see the surgeon again after the operation?
Bring your child to the surgeon's office for a postoperative visit two weeks after the operation. During this visit we check the size of the anal opening. Most children have to be dilated, or have the anus stretched, each day to prevent the anus from becoming too tight. You will be given a set of anal dilators to take home with you from the hospital. Bring them to your baby's first surgical appointment and if dilations are necessary, we will show you how to do them. Dilations usually last a few months.
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
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