Maplewood Oral and Maxillofacial Surgery

INFORMATION FOR YOUR HOSPITAL OR DAY SURGERY

YOUR SURGICAL PLAN
Please read carefully.

After reviewing your case with you, the surgeon has determined that you will need to undergo a surgical procedure, which will be performed in the hospital. If you have any questions regarding your upcoming surgery or what is involved with the procedure, please contact our office so we can discuss this further with you.

In order to be cleared for surgery you will need to have a pre-operative physical examination completed by your family doctor. Your physician may dictate this physical examination directly to the hospital or complete the enclosed form. If your doctor completes the form, you will need to bring it with you to the hospital. This history and physical examination should be done within the two weeks prior to your surgery date.

You will be admitted to the hospital the morning of surgery. Please report to the admissions desk to complete any paperwork and provide your insurance cards. Prior to your surgery, you will have the opportunity to visit with the anesthesiologist who will be putting you to sleep (general anesthesia). If you have questions regarding anesthesia, please discuss these with the anesthesiologist.

Following your procedure you will be transferred to a recovery area until such time as you are fully awake and stable. You will then be discharged or transferred to your hospital room. If hospitalized you should anticipate staying in the hospital one to three days after your surgery. This will vary depending on the nature of your surgery and your rate of recovery. When you are finally discharged you will be given post-operative instructions, prescriptions and a reminder to call our office for your follow up care.

This booklet provides information that will help you during your recuperation period. Should you have additional questions, please call our office.

GENERAL CARE

Keep your head elevated on two (2) pillows or elevate the head of the bed somewhat. Ice may be used as needed for comfort.

You may shower if you are steady with walking. Prior to showering, apply a small amount of Bacitracin ointment to any external wounds. After showering, remove the old ointment and re-apply new ointment. This will protect the wounds from any debris that may wash out of the hair.

ORAL HYGIENE

Use a small, soft (baby) toothbrush and fluoride toothpaste to clean your teeth. Be gentle in the surgical area(s). Rinse your mouth with warm water, warm salt water, Cepacol, or a mixture of hydrogen peroxide and warm water (1:2-3). This should be done upon rising in the morning, after every meal, and before bedtime. This is very important in order to prevent infection in the surgical area(s). Do not use a water pick to help clean your teeth/mouth during recovery days. A water pick can put too much force on the surgical area(s). If you are used to using a water pick, check with your doctor before restarting. Put Vaseline on your lips as needed for dryness.

Do not put removable orthodontic plates and speech appliances into your mouth without your doctor’s approval. He will let you know if and when they are needed.

WOUND CARE
(if facial incisions are present)

Keep your incision(s) clean and dry. You should put the antibiotic ointment on the incision(s) during the day or as ordered, and before and after you shower. This will help to prevent infection and minimize scarring.

If possible, avoid blowing your nose for seven to ten days after surgery as this puts extra stress on your incision(s).

ACTIVITY

The activities that you do, such as walking, running, and/or exercising can be resumed as you are able. You should avoid contact sports and any activity, which could result in a blow or bump to your mouth or face, until your doctor says otherwise. If applicable, keep the wire cutters with you at all times. They should be used only in an emergency.

Your doctor will determine when you should start exercising your jaw and which exercises you should do. You may see a physical therapist, who will explain and show you the various exercises. It is very important that you follow this exercise program closely as it will help you to restore motion and function to your jaw.

MEDICATIONS

The amount of discomfort people have when they leave the hospital varies. You should take the pain medicine that your doctor prescribed as directed. Your doctor may want you to continue antibiotic medicine at home. If your doctor ordered other medicines, such as ear or nose drops, take them according to his instructions. Read the label on the bottle(s) or package(s) carefully.

FOLLOW-UP MEDICAL CARE

Your first follow-up visit will be in five to seven days after leaving the hospital. Usually an appointment will be made for you. If an appointment is not made for you, call the office to schedule.

Contact your doctor if you have an increase in swelling, pain, drainage, a temperature over 100 degrees, or any other questions/concerns.

NUTRITION

Your nutrition is the single most important factor in your recovery. You require protein, calories, and plenty of liquids to aid in your healing. A general guideline is to double your usual caloric and liquid intake. You may find it helpful to eat 5 - 7 times a day in order to meet your body’s needs. Drink liquids that have good nutritional value such as fruit juices and dietary supplements such as: Meritene, Sustacal, Ensure, or Carnation Instant Breakfast. Avoid filling up on water, coffee, tea and diet soft drinks. Fruit juices will also help to break down any secretions.

Some suggestions to add variety include: soups, juices, Jell-O, ice cream, milkshakes, strained baby food, liquid instant breakfast, milk dietary supplements, and blenderized food. Make sure the foods are very liquefied and require no chewing. Refer to the dietary books for recipe ideas. If you develop diarrhea from the dietary supplements, try diluting the supplement with water.

Do not use straws for the first seven days as they could cause bleeding, wound breakdown, and stomach bloating.

You should weigh yourself every other day. You can anticipate losing five to fifteen pounds within the first two weeks after surgery then your weight should stabilize or begin to increase.

You will progress to a diet of soft foods when your doctor gives the okay. Soft foods, which are allowed to be eaten during your recovery period are listed on the following page. These foods will require chewing, and therefore more jaw movement. Let your doctor know if this causes a great increase in discomfort.

Description	Allowed	Avoid
Beverages	Any with emphasis on milk, chocolate milk, cocoa, eggnog, malts, milkshakes, instant breakfast, nutritional supplements Limit use of carbonated beverages, fruit drinks, Kool-aid, lemonade, etc. which supply only calories	None
Breads	None	All
Cereals	Smooth, refined hot cereals to include Cream of Wheat, Cream of Rice and Malt-o-Meal, thinned with hot milk	Oatmeal, pettijohns, Ralston, dry cereal
Desserts	Melted gelatin, fruit ice, sherbet, flavored ice cream and ice milk. Thinned puddings, thinned yogurt, Popsicles, pudding pops, fudgsicles, and creamsicles, strained baby desserts-thinned	Products containing pieces of fruit, nuts and chips
Fats	Butter, margarine, half & half, whipped cream	Any others
Fruits	Strained fruit juices, sweetened pureed fruits and strained baby fruits-thinned with fruit juice	Any others
Meats	Pureed meats thinned with broth or added to strained cream soups, cubed cooked meat or poultry pureed with broth or cream soup, pureed spaghetti sauce thinned with tomato juice or sauce, other thinned pureed casseroles. Melted cheese added to cream soup. Eggs used in pudding and/or eggnog	Any others
Potatoes	Thin mashed potatoes with butter and/or gravy	Any others
Soups	Pureed broth soups, strained creamed soups	Any others
Vegetables	Cooked and pureed vegetables or strained baby vegetables-thinned with cooking liquid or added to soups. Strained vegetable juices	Any others
Miscellaneous	Ground spices, seasonings, ice cream toppings, gravy	Any others

NOTE:

Double milk may be used in preparation of milk-based items, e.g., cream soups, puddings, milk shakes, hot cereal, potatoes, etc. It may also be used to thin puddings, etc. “Double Milk” is 1 cup powdered milk added to 1 quart whole milk.
Powdered milk may be added to soups and beverages or any other food item in which it would mix well.
Nutrition supplements as recommended by your dietitian or physician may be used when needed.