The pectus carinatum repair is a painful procedure. The length of stay in the hospital is mainly determined by postoperative pain management. You can help your child’s recovery by encouraging deep breathing, sitting in a chair and walking soon after the operation.
Before your child leaves the hospital, the surgeon may order a custom chest brace to be made and worn at home. The orthotics specialist will fit your child for the brace and provide instructions regarding proper use, before you leave the hospital. Your child’s surgeon will discuss this with you at the time of the operation.
- Pain Management
- Care for Dressings
- Swelling After Surgery
- Bathing Restrictions
- Activity Restrictions
- Do I see the surgeon again after the operation?
- When do I call the surgeon's office?
Pain Management
Before discharge home a prescription for pain medication will be given to you to take to your local pharmacy. If your pharmacy will be closed by the time you arrive home, you may have your prescription filled at a pharmacy near the hospital. Please talk to the pediatric pharmacist before you leave the hospital to make these arrangements. For some patients, several different medications may be used, for example, Tylenol with codeine alternating with ibuprofen. It is important to follow the pain management protocol prescribed by your surgeon to minimize your child’s discomfort.
Care for Dressings
The gauze and clear plastic dressings may be removed two days after surgery. Covering the incision(s) will be white strips of tape called Steri-Strips. There may be a small amount of blood on the Steri-Strips; this is normal. The skin surrounding the incisions may be bruised or slightly swollen; this get better quickly. Your child can bathe with the Steri-Strips in place. They will fall off on their own and do not need to be removed.
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 2 weeks of the operation, please call our office.
Swelling After Surgery
There may be a slight amount of swelling around the area of the incision that should get better in a few days. Swelling that does not go away or worsens should be reported to our office. About 3-4 weeks after the operation you may feel a lump under the incision. This is called a healing ridge and is normal. This lump may last for several months before it softens and goes away. At about the same time, in some patients, the dissolvable sutures may come through the incision appearing as little white strings. This is normal and these will fall off on their own. Sometimes there is a little redness where the sutures come through the skin; this is not an infection but irritation that will go away on its own.
Bathing Restrictions
Your child may bathe or shower after the epidural catheter is removed. Once your child is home, he or she may bathe or shower without restriction. Try not to rub off the Steri-Strips; have your child blot them dry when s/he finishes bathing.
Activity Restrictions
Your child will need to avoid contact sports, vigorous exercise, and other activities for which there is the potential for a high-velocity impact, such as bicycling, for 3 months, while your child’s chest heals.
Do I see the surgeon again after the operation?
If all is going well, we recommend a visit to our office 2 –4 weeks after the hospital discharge. A visit to your child’s pediatrician one to 2 weeks after hospital discharge is also recommended. Call our office at any time if you are worried about your child’s recovery. If your child is wearing a brace, he or she will need to return to the orthotics department periodically to assess and adjust the fit of the brace to maximize its effectiveness. We will make every effort to coordinate appointments on the same day.
Call our office at 415-476-2538 for the following:
- Any concerns you have about your child’s recovery
- A temperature of 101.5F or higher
- A red incision
- Increasing pain and tenderness of the incision
- Fluid coming out of the incision
- Any difficulty breathing or recurrent chest pains