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Surgical Period
You will be
transferred to the recovery room following the surgical procedure. Your
progress will be closely monitored by the recovery room nurses. Your length
of stay in the recovery room will depend on the length and type of procedure.
It is possible that you may spend the night in the recovery room.
Swelling
You can anticipate
that swelling will occur and the degree of swelling varies in different
individuals with different procedures. Swelling will continue to increase for
approximately 48 hours following surgery. The swelling of the lips can be
minimized by utilizing the medicated cream which will be available at the
bedside.
Swelling typically
remains unchanged until approximately one week following surgery, and during
the second and third weeks following surgery, begins to subside dramatically.
Every attempt will be made to minimize the swelling during the period of
hospitalization. Ice packs will be used immediately following surgery, and
you will be given a special type of medication (steroids) prior to surgery,
which will be continued during your period of hospital stay. You will be
encouraged to keep your head elevated for the first week following surgery,
since an upright posture and early ambulation minimize the swelling which may
occur. Remember, swelling is just the bodies response to surgery and will
subside.
Nausea and Vomiting
You may experience
some nausea and vomiting. It is important to realize that this is not a
life-threatening situation since your stomach is empty. Therefore if vomiting
does occur, remain calm and turn your head to the side so that any fluid
produced clears your mouth freely. Although wire-cutters are attached to the
head of the bed so that they can be available in an extreme emergency, it is
very unusual to have to cut the wires that hold your jaws in position. The
nurses who care for you are accustomed to dealing with patients who have
their jaws wired together.
Minor Bleeding
Following Surgery
It is common to
experience some degree of minor bleeding following surgery, and minor nose
bleeds may be expected for a period of one to two weeks following upper jaw
surgery. Appropriate medications are given to decrease nasal secretions.
Clear Liquids
 It will be important that you
drink a sufficient volume of fluids to allow the discontinuance of the
intravenous fluids. An average adult requires approximately two to two and
one-half quarts of fluids every 24 hours. While this may seem like a large
quantity, it can be achieved with constant sipping.
As soon as possible, you
will be encouraged to drink clear liquids. A large cather-tipped syringe will
be available to assist you in taking fluids while in the hospital. You will
be encouraged to drink directly from a cup or glass after discharge.
Speech
The ease with which
you can communicate and can be understood is not predictable; speech will
only improve, however, by repeated attempts on your part to talk and be
understood. It is important that you slow your rate of speech, concentrate on
each word; and be willing to try repeatedly. Most patients can be understood
within 24 hours of surgery.
Post-Operative
Discomfort
Discomfort may be
anticipated; in most instances, however, it is mild and treated easily with
medication. Many patients have indicated that the removal of impacted wisdom
teeth produced more discomfort than orthognathic surgery.
Nasal Stuffiness
Nasal stuffiness
occurs both from tubes placed during surgery and from surgical procedures in
the upper jaw. When this occurs, it can be managed with a combination of
nasal sprays and cleansing of the nostrils. It is suggested that you remove
nasal secretions using Q-tips soaked in water. When you use the Afrin or
Neo-Synephrine Nasal Spray, it should be sprayed with sufficient force for
you to taste the medication.
A buildup of nasal
blockage can happen as drainage occurs from the nose. Nasal obstructions can
occur and nasal breathing will become impaired. If you feel this buildup
occurring please draw it to the nurse's attention at once.
Walking
You are encouraged to
walk as soon as possible. The movement of getting you back on your feet early
in the post-operative period is healthy for all body systems and can help to
shorten your hospital stay.
Medications
During the period of
hospitalization, you will usually be given antibiotics, pain medication,
(nasal spray, medicated cream for your lips, and a high dose of a
multi-vitamin). These will be continued on discharge from the hospital. You
will be given specific instructions as well as have all questions answered
upon discharge.
Post-Operative
Depression
Expect some
post-operative depression. This usually occurs on the second post-operative
day and we call it the second day "blahs". Don't let it concern you
as it is very common among patients undergoing this type of surgery.
Cleaning Teeth When
the Jaws are Wired Together
You will be
encouraged to brush and use the "water-pic" following each meal. A
soft toothbrush can be utilized for this purpose, paying particular attention
to keeping the brush in direct contact with the teeth. In addition to this, a
mouth rinse should be used. It is suggested that you add 1/4 teaspoon of salt
diluted in 1 glass of water 3-4 times daily. A "water-pic" along
with a toothbrush will provide an excellent means of oral hygiene following
surgery.
Weight Loss
A weight loss of 5-10
pounds may be anticipated during the post-operative period. This is a
reflection, in most instances, of a loss of appetite rather than than the
fact that the teeth are wired together. By one week following surgery, your
appetite should be sufficiently improved to maintain and possibly increase
your weight.
Smoking
If you smoke, we
request that you do not smoke during the period that your jaws are wired
together. Heavy staining will occur to the teeth, braces and splint as well
as a retardation of wound healing if you do smoke during this period.
Do's and Don’ts
-Do not blow your
nose if you have had maxillary (upper jaw) surgery
-To sneeze, push on
your cheeks so they won't fill up with air or sneeze out of your mouth
-Change of pressure
(elevator, non-pressurized airplane) can be painful
-Sleep with your head
elevated
-Be prepared for nose
bleeds or a "runny" nose
-When you have the
elastic bands removed and still have a splint intact, maintain your soft,
liquid diet.
-Don't be afraid if
you have to vomit. Turn your head to the side and allow the liquid to drain
from your mouth
-Don't exert yourself
or do any exercises that may cause heavy breathing
-Carry scissors with
you at all times if you have the elastic bands in place in your mouth
-Avoid any foods,
liquids or alcohol that may upset your stomach
AAOMS
Nutrition Recommendations
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