Neurosurgical post-operative advice

The aim of this information is to give you basic advice about caring for your child at home after they have undergone a neurosurgical procedure. It will include some general neurosurgical advice as well as a space for you child’s nurse to write any specific care instruction for your child at discharge.

Surgical wound care

A surgical wound is the cut made into the skin by a surgeon during an operation. At the end of the operation the cut is sutured (stitched) together to allow the skin edges to come together and heal.

Some sutures dissolve by themselves in time. Some sutures need removing and they are usually taken out 7 to 10 days after your child’s operation.

It is important to keep your child’s surgical wounds clean and dry following surgery in order to give to the wound time to heal and to reduce the risk of infection.

Some wounds have a dressing bandage over them to protect the area, and will need to stay on for at least 48 hours post-surgery. Your nurse will supply you with spare dressings and bandages in case the original becomes dirty or should you be advised to keep the wound covered for longer.

You should contact the neurosurgical nurse specialist or Ward S2 directly if you have any concerns about your child’s wound.

Things to look for include:

• any leakage including fresh blood, clear fluid, or pus
• if the wound appears to be re-opening
• worsening redness
• hotness around the wound
• bad smell coming from wound
• increased swelling
• increased pain at the wound
• blisters or rash on or near wound

Pain relief

A surgical wound can be painful and your child will be given appropriate pain relief during their admission to keep them comfortable. Some children will still require pain relief for a few days after discharge. You will be advised about this before your child leaves the ward. Once home, if you feel that your child’s pain does not improve or becomes worse, please phone the ward for advice.

Bathing, hair washing and swimming

A wound should be kept dry for at least 7 days. For head wounds, hair should not be washed for at least 7 days or until the sutures are removed. If your child had dissolvable sutures, you should avoid conditioner until the sutures have completely disappeared as it can stop them from dissolving.

Swimming should be avoided for at least a month.

Follow-up

Patients who need a wound check and or suture removal will be seen 7 to 10 days after surgery. Depending on the time of surgery, you may be asked to bring your child to Ward S2, to an outpatient’s clinic or to arrange an appointment with the practice nurse at your GP surgery. You will be told which one of these is appropriate for your child before discharge.

Your child may also require an outpatient clinic appointment, usually 4 to 6 week after discharge. This may be with a neurosurgeon or a clinical nurse specialist. You will receive a letter through the post with details of when this is.

Some children can be referred on to other health professional or support groups for follow up and support after their surgery, in relation to their specific condition. You will always be asked to consent before your child is referred to any of these services.

Returning to nursery or school

This depends on the operation your child has had and how well they recover from surgery. Some children require a phased return as they find they are more tired after surgery. Others may require adaptations to be made before they can return. This will be discussed with you at discharge. We would be happy for you to give your child’s school or nursery the nurse specialists contact details should they require any advice on supporting your child as they return.

Post-operative instructions specific to your child

Your child’s head bandage should be removed on //

Your child’s dressing should be removed on //

Your child’s sutures are dissolvable:    Yes      No

If no, your child’s sutures should be removed on //

Your child’s wound check-up appointment is on // at

Your child’s follow-up appointment is on // at

Your child’s pain relief is

Notes on your child returning to school or nursery

Other notes