Routine postoperative care

This course is part of the RCOG Core Knowledge series.

A successful surgical procedure consists of 3 essential steps: the preoperative assessment and patient’s preoperative preparation, the surgery itself and the postoperative period. They are all equally important.The postoperative care contributes greatly to the success of an operation; it has changed dramatically in the last decade.

Example:

Previously

It was routine for women to remain in hospital on bed rest for up to two weeks following a hysterectomy.

Today

There are units where day-case laparoscopic hysterectomies are routinely performed.

These changes have been driven by a number of factors.

1. An improved understanding of the response to the surgical stress:

• changes in water and electrolyte balance
• blood clotting
• a metabolic, digestive and excretory systems response to pain
• the psychological response to the trauma of surgery.

2. An understanding of the dangers of a prolonged hospital stay increased risk of:

• infections
• thromboembolic complications.

3. Economic considerations.

4. Efficient and robust systems to allow sufficient flexibility for an individually tailored approach to patients.

This course explores the evidence surrounding some of the major components to postoperative care, while not considering the treatment of pre-or postoperative complications as this is covered in other Core Knowledge courses.