No matter the type of surgery your child has, he or she will go directly to our pediatric intensive care unit (PICU) right after surgery. Your child's head will be fully wrapped with a turban dressing and will be elevated. Sticky pads on your child's chest give readings to monitor the heart. A red light on your child's finger or toe tells if the blood is getting enough oxygen. Through the IV that was placed before the surgery, your child will get needed fluids and medications. Every six hours for up to two days, a blood sample will be taken to make sure your child is recovering as well as expected.
Your child will be sleepy the first day and will be able to take a bottle the evening of the surgery. Two days after surgery the head dressing will be removed.
When the blood counts are stable, your child will move from PICU into a regular room, and you'll be able to hold your child even though the head and face swell after surgery. The worst swelling occurs two to three days after surgery. Often the eyes swell shut, which may frighten your child. Parents' voices and familiar music and sounds help comfort your child.
You can take your child home on the fourth or fifth day after surgery. Head and face swelling will be improved, but the swelling around the eyes will come and go for two to three more weeks.
If your child sleeps face down, he or she will awaken with the eye swollen shut. The incision will appear red and swollen. After one or two hours, this swelling will go away. In order to reduce or prevent swelling, we recommend that you put your child to sleep on his or her back for several weeks after surgery. If you notice that he or she rolls over, reposition the child onto his or her back and keep the head up.
Once home, your child may have the days and nights confused. To lessen the effects of this adjustment, provide periods of play during the day in a bright room.
If your child is under four years of age, administer regular children's Tylenol as directed for his or her pain and irritability. Children older than four years may be sent home with a prescription for Tylenol with codeine.
Once your child is home, resume a regular diet. There are some restrictions immediately following surgery, but since your child will be spending several nights with us, we will restrict the diet as needed during that time.
You should wash your child's incision each day with a mild shampoo (see home care instructions for a child with cranial incision lines). Do not use cream rinse or any lotions on the head until the skin heals completely.
Cover your child's head when going outside; the incision gets sunburned very easily.
Your child may return to usual activity levels when you go home. Remove low-lying furniture with sharp edges such as coffee tables to prevent possible head injuries.
We recommend that you keep your child home from school or daycare until the first follow-up visit.
No medications are prescribed routinely following surgery. If your child complains of pain at the site of the incision, give Tylenol.
Your child should shower with mild baby soap or shampoo daily. A sponge bath with mild soap followed by rinsing with clean water is fine for smaller children. Do not allow the wound to soak in the bath tub.
Make sure you have your follow-up clinic appointment scheduled for seven to 10 days after the surgery. Six weeks after surgery your child will have a follow-up appointment with the surgeon. You may also want to schedule other appointments with members of the craniofacial team such as plastic surgery and speech pathology.
These appointments should be scheduled before you take your child home from Cincinnati Children's. If they are not, please call us at 513-636-4726.