How to take care of appendicitis after surgery? Start with the wound, activities, and diet!

Author: Sun Meng, deputy chief nurse, Beijing Friendship Hospital, Capital Medical University

Reviewer: Shi Wenzai, attending physician at Peking University International Hospital

Appendicitis is a common abdominal surgical emergency. During its clinical diagnosis and treatment, the patient's clinical manifestations are often complex and changeable, so misdiagnosis and missed diagnosis are prone to occur, causing the patient's condition to worsen or causing a series of other complications.

Figure 1 Original copyright image, no permission to reprint

Surgery is the main treatment for appendicitis. Some complications may occur after surgery, such as infection, bleeding, etc., so postoperative care is particularly important.

Let us now learn about the care knowledge after appendectomy.

1. How to care for the wound after appendicitis surgery?

First, keep the wound clean and dry, avoid water immersion and contamination, and change the dressing on time. Pay attention to the color of the wound and whether there is swelling and exudation. If there is obvious redness and swelling, increased exudation, and high skin temperature, it may be a sign of wound infection. Tell the doctor in time for treatment.

After the surgical anesthesia reaction disappears, wound pain will occur. Generally speaking, the pain is more obvious on the first day after surgery, and then it will gradually decrease and disappear. Different methods can be used to relieve it according to the degree of pain. Mild pain can be relieved by distracting attention, such as watching TV series, movies, listening to music, chatting with family members, etc., to maintain a happy mood and promote recovery. If it is really difficult to tolerate, it is recommended to use analgesics to relieve the pain.

If a drainage tube is placed after surgery, be careful not to bend or twist it, and pay attention to the color, amount, and nature of the drainage fluid. If there is a lot of exudate in a short period of time, it should be a cause for concern. When getting out of bed, pin the drainage bag to your body, and the position should not be higher than the incision to avoid reflux infection.

Avoid strenuous exercise and excessive force for a period of time after the operation to avoid damage to the wound. For example, when coughing or getting out of bed, the movements must be gentle, and the wound area should be gently pressed with the hands to avoid discomfort caused by traction. At the same time, you should maintain good personal hygiene habits, wash your hands frequently, and do not touch unhealed wounds with dirty hands to avoid infection. After the scab forms, it is recommended to wear loose and breathable clothing to avoid rubbing the wound.

Taking open surgical incision as an example, it usually takes about 10 days to heal gradually. At this time, do not tear off the scab manually, wait for it to fall off slowly to reduce scars or pigmentation.

You can take a shower after the wound heals. It is best to choose a shower instead of a bath. Use a clean towel to wipe the area around the wound, controlling the strength. You can also cover it with some waterproof dressings to avoid getting the wound wet when taking a bath.

2. When can I get out of bed and move around after appendectomy surgery?

Early mobilization is very important, and the time to start mobilization after surgery depends on the individual patient, the severity of the disease, and the recovery process.

After waking up from anesthesia, you can lie in a semi-recumbent position to reduce abdominal tension, reduce the load on cardiopulmonary function, promote wound healing, and prevent the spread of inflammation. You can get out of bed and move around after about 6 hours. If you are physically weak or have many complications of the appendix, such as perforation or gangrene, you can postpone getting out of bed. You can start by moving around in bed and gradually transition. When moving, avoid turning your body suddenly to cause pain in the wound.

When you have recovered well and there is no obvious discomfort, you can try sitting up and raise the bed by 30 degrees. After you get used to it, raise it to about 60 degrees. Slowly adapt to this change in body position and then slowly sit on the edge of the bed with your legs hanging down. Stand up slowly and walk with small steps after you have stabilized yourself. At first, you can move around near the edge of the bed, and then gradually increase the range and time of activity.

Figure 2 Original copyright image, no permission to reprint

3. What should you pay attention to in your diet after appendectomy surgery?

During the postoperative recovery period, a reasonable diet is essential to promote wound healing and physical recovery. You can eat only after the anus is exhausted. For example, in laparoscopic simple appendectomy, you can generally drink water 6 hours after the operation. If there are other complications, you need to follow the doctor's advice and eat under the doctor's guidance.

The diet should follow the principle of starting from liquid food, semi-liquid food, soft food, and finally normal food. You can start by drinking a small amount of water, 30-50ml each time, about 6-7 normal spoons. It is recommended to drink more water rich in vitamins, such as orange juice, etc. It is not recommended to drink foods that are easy to produce gas, such as milk and soy milk, which can easily cause abdominal distension after surgery.

If there is no nausea, vomiting or other discomfort after drinking water, you can slowly increase the amount of water you drink. After the gastrointestinal function gradually recovers, you can eat liquid food, such as oil-free chicken soup, vegetable juice, lotus root powder, rice soup, etc., and then slowly try semi-liquid food, such as wontons, noodles, porridge, etc. After eating, observe for abdominal pain and bloating. If you can tolerate it, you can increase the amount of activity. Getting out of bed and moving early can better help restore intestinal function. Then choose easily digestible food and slowly transition to a normal diet.

In general, avoid eating spicy, greasy, raw, cold, or dry and hard food after surgery, and follow the principles of eating small meals frequently, easy to digest, avoiding excessive intake at one time, and taking a step-by-step approach.