Post Operative Care After Undergoing Reconstructive Jaw Surgery Dressing/Wound Care: You have just undergone a technical surgical procedure to reconstruct your jaw deformity. On discharge, you will note that there is a pressure dressing on your face or jaw that will be kept in place for 24 hours. This will decrease the overall swelling and act to give you a better overall result. There also may be adhesive tape or Steri-Strip dressings on your upper lip, chin or on the sides of your face; these dressings will be removed after 1 week. Mouth: Your jaws are not wired shut. Although they may seem to be so, they are held together by elastic bands. These elastic bands maintain your bite in the appropriate position. They will limit your ability to open your mouth, however, you still should be able to have some mobility. You will also notice that you may have a plastic splint between your upper and lower teeth. This plastic splint is an index used at the time of surgery to align your bite properly. This index will be removed after the second or third week. Blood Around Nose/Mouth: You also will experience some blood in your mouth and possible in your nose. This is normal and to be expected. You can clean the blood form the sides of your nose with a Q-tip soaked in half-strength peroxide. You can get a bottle of 3% peroxide at the drug store and dilute it 50/50 with regular tap water, then clean around the outside of your nose with the Q-tip. Do not push the Q-tip deep down into the nasal passages because this can actually increase the tendency for bleeding. You can also use the half-strength peroxide to rinse your mouth. We encourage you to rinse your mouth with the half-strength peroxide at least 3 times per day. This not only helps with healing, but will remove any old, clotted blood from around your teeth. Keep your lips moist using Vaseline or a steroid cream product. Keep the ice packs on your face for 24 hours. After 24 hours, you can use moist, warm packs. Keep your head elevated on 2-3 pillows at tall times. This also reduces the postoperative swelling. Remember that the swelling maximizes after the second day and then starts decreasing. Make sure to stay out of direct sun because this will also increase the tendency for swelling. Diet: For the first 24 hours, you should be on a clear, cool liquid diet. Liquids such as apple juice, cranapple juice and clear broth are probably the best. Try to stay away from acidic drinks such as orange juice and grapefruit juice, since this will tend to upset your stomach. Also stay away from milk products for the first 24 hours. After 24 hours, you can increase your diet to full liquids. This will include milkshakes and thicker soups. Again, we recommend that you stay away from acidic drinks. Make sure that you rinse with the half-strength peroxide after you drink any thick fluids to maintain the cleanliness of your mouth. After 48 hours has passed, you can consult the diet book that you were given during your preoperative instructions and utilize any of the diets in that book called, "Drink to Your Health". You can also use over-the-counter products such as Sustacal, Ensure or Instant Breakfast. You can mix this with protein supplements that you can purchase at local nutrition stores. Medications: You have been sent home with a number of medications to help you during your post operative course; they include a medication for pain, which is liquid. You can take this every 3 hours for pain. Make sure that you that you do not take the pain medicine more than it is prescribed since side effects from pain medicine include nausea and vomiting, which are something that you want to try to avoid experiencing. You have also been given liquid antibiotics to take. You are to take these liquid antibiotics 4 times per day until completion of your prescription. These are suppositories and are to be taken when nausea becomes a major problem for you. Do not take more than 4 of these medications over a 24 hour period. Activity: Try to stay in a cool, comfortable location in your house and keep your activity down to a minimum for the first 2 days. As you begin to feel better, you can increase your activities. Do not attempt to drive a vehicle when you are taking narcotic pain medications. Hygiene: Oral hygiene is critical in keeping your wounds clean. Rinse with the half-strength peroxide or Peridex, depending on what the doctor has given you. You should rinse at least 3 times per day vigorously. If you have a Water-Pik, put it on low and put the peroxide or Peridex in the Water-Pik and use that to clean your mouth. Start utilizing a toothbrush at the earliest possible time. We recommend that you purchase a small (pediatric) soft toothbrush to clean the outside of your teeth. It will be very difficult to clean the inside of your teeth until your are able to open more freely. Bathing: We would recommend taking a bath rather that a shower for the first 24 hours since you can get dizzy standing for any length of time after having a general anesthetic. Once you start feeling stronger, you can begin taking showers. The wounds can become wet after 24 hours. If you were required to have bone harvested form hour hip to reconstruct your face or jaws, there will be a bulky dressing on your hip. You will want to keep this dry for 24 hours. After 24 hours, you will find a sealed occlusive transparent dressing that we would like you to keep on the wound for at least 1 week. You can bathe with this dressing intact. Rehabilitation: You will note that your hip is sore when you attempt to lift your leg up or when you attempt to transfer yourself, either getting out of bed or getting out of a chair. Try to do these movements slowly, supporting yourself with your arms. Do not attempt to lift any heavy weights or bend down and stand up quickly. We would recommend that you rest in bed (or a chair) with your leg elevated for the first 48 hours, walking in a pool is very therapeutic and helpful in regaining your strength and decreasing the pain in the muscles around the graft site. Returning to Normal Exercise: We would recommend that you do not attempt any vigorous exercise for at least 3 weeks after undergoing surgery. If you have had a hip graft, we would recommend no vigorous exercise for 6 weeks. Walking, stretching and doing gentle calisthetics in a pool are very helpful in your rehabilitation. Call Our Office if you should have any of these symptoms: Severe nausea Inability to swallow Inability to tolerate liquids Excessive Swelling Difficulty Breathing Doctors are available 24 hours a day to take your call We hope this web site provides you with adequate information for your postoperative course. If you should have any questions, please do not hesitate to ask our nursing staff or the doctors. We hope that your postoperative surgical course is as comfortable as possible.