After Incision & Drainage (I&D)
PAIN: Some degree of pain is normal for all patients after the procedure. Unless contraindicated, we generally recommend taking ibuprofen (also known as Motrin, Advil). If pain is not controlled with ibuprofen alone after 1 hour, you can take EITHER a plain acetaminophen (also known as Tylenol) OR the acetaminophen-narcotic combination painkiller (Norco, Percocet, Vicodin, Tylenol#3 / codeine) to control pain. Do NOT mix plain acetaminophen (Tylenol) if you are currently taking another medication that already contains acetaminophen such as one of the painkillers mentioned above to avoid an acetaminophen-overdose.
Please note: Narcotics are habit-forming medications, so use as little as possible. Please be aware that narcotics cause drowsiness and sometimes nausea; do not drink or drive while on these medications, or combine with other medications that cause drowsiness without speaking to your doctor first. Always consult a physician or your surgeon prior to using any additional medications or methods that were not discussed prior to your discharge. If your procedure was performed in the hospital under general anesthesia while completely asleep, know that a sore throat is extremely common; this is from the breathing tube that was placed down your throat, and this pain should resolve quickly, especially with consumption of cool liquids.
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BLEEDING: Slight oozing of blood from your surgical sites is normal for the first day or so after surgery. In the event of excessive bleeding that cannot be controlled; wet plain black tea bags and place it over the site and apply firm constant pressure. If it doesn’t stop, inform your doctor or report to the nearest emergency room.
Remember, slight bleeding is acceptable, and the saliva in your mouth mixed with a small amount of blood may create a more drastic appearance than is actually the case (like a drop of food coloring in a glass of water). Do NOT spit, smoke, or drink from a straw: these will dislodge the necessary and protective embedded blood clots in the surgery site. When dislodged; bleeding, pain, and delay in healing can result.
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SWELLING: Swelling is also quite normal after this surgery. This swelling will peak at about day 3 after surgery and then should gradually resolve on its own. In order to lessen the amount of swelling, please use Ibuprofen unless you are unable to take it and sleep with your head elevated using many pillows. It is intuitive to apply ice packs to your face, but in your situation, warm heat is necessary to promote antibiotic-blood flow to your infection site.
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THE DRAIN: Depending on the situation, your surgeon may have decided to keep the incision site open/patent by stitching a drain or medicated packing into the incision site. When your incision site is kept open, it prevents abscess/pus from building up again. This drain can not stay in your mouth more than 3 days. If your drain/packing happens to fall out before your next visit, please inform our office during normal business hours.
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CARE OF THE NOSE AND SINUSES: If you had surgery on your upper jaw (maxilla) it is important to know that the necessary surgical treatments occurred in the area in close proximity to your nose and sinuses. As such, some degree of swelling and local changes in the area have occurred. This is why many patients complain of sinus congestion and difficulty breathing through their nose. This is normal, though it is important to take certain measures to ensure a good surgical outcome and optimize your own comfort.
For the next 4-6 weeks, you should avoid blowing your nose, sneezing through your nose, or bending over.
Remember, Nasal congestion may create a feeling of not being able to breathe. If this occurs, stay calm, and take an “over the counter” decongestant, like a nasal spray or pill, (if this ok with your MD). Simply follow the instructions on the label. A humidifier and propping yourself up with pillows at night will also help. Please note, these measures may not completely eliminate the congestion right away, but they can only help.
Sometimes minor nose bleeding can occur after nose or sinus surgery; this is common and nothing to be concerned about. The bleeding should be minimal and resolve on its own with some light squeezing of your nose. If the bleeding is excessive or is not stopping, call us immediately.
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DIET: For the next week you should only be eating food that is soft, cool, and easy to chew. Do NOT eat anything spicy, hot, crunchy, tough to chew, or anything through a straw.
Your jaws are fragile after surgery, so you do not want to chew hard or tough foods.Sharp/Crunchy foods can poke your surgery site and break stitches causing pain and bleeding.Hot temperature, carbonated, and Spicy items cause blood vessels to open and cause bleeding.Using straws will cause bleeding.
Foods that are safe to eat include yogurts, shakes/smoothies, ice cream/sorbet, pasta, mashed potatoes, scrambled eggs, etc. Almost anything you can put into a blender is acceptable as well.
** Always remember to rinse your mouth out gently with water after every meal.
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HYGIENE: Beginning tomorrow, you may gently rinse your mouth out with warm water/salt solution every meal. After one day, resume your regular brushing routine, just be gentle near the site of surgery. You may use mouthwash as long as it is alcohol-free and if you do NOT spit ( just lean over the sink and let the fluid fall out of your mouth). Try to keep it clean by rinsing your mouth out to avoid post-op infections, bad breath, or bad taste in your mouth from retained food/debris.
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ACTIVITY: You should avoid the gym and/or any strenuous activity or exercise for the next 3-5 days. Light out-of-bed activity (walking, shopping, etc) starting the day of your surgery is mandatory to prevent blood clots and other pulmonary issues. Most patients who undergo this procedure are able to return to work/school after two days. Remember, a gradual return to your normal daily activity is the most sensible approach. Smoking is strictly prohibited; smoking will jeopardize the success of your case and can result in delayed healing, infections, implant/graft failure, and pain.
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FOLLOW UP: Please make sure to schedule and present to your follow up appointments, in order to optimize your outcome and monitor the site.
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WARNING SIGNS OF COMPLICATIONS: Please be aware of these possible complications and inform your doctor if you encounter them. In the event of a life-threatening emergency, or if you can not reach your doctor, please call 911 and report to the nearest hospital emergency room.
Prolonged numbness or tingling sensation 8+ hours after your procedure (Call ASAP).Excessive bleeding not controllable by constant pressure over the site (Call ASAP).Pus or foul odor/taste from surgical sites.Fevers/Chills (Although can be normal up to 2 days after general anesthesia).Progressive severe pain and/or swelling after the first day of surgery.Nausea/diarrhea (especially while taking antibiotics)Difficulty breathing or swallowing liquids (Call ASAP)
Feel well, and if you have any questions or concerns please feel free to contact us at any time.