POST-OPERATIVE CARE OF THE PATIENT OPERATED UNDER GENERAL ANAESTHESIA:

- The patient should be kept nil[ by mouth (NBM) till he/she regains consciousness.
- 2.5-3.0 litres of i.v. fluids should be given in 24 hours. (I.V. therapy should be planned in such a way
that a proper balance of fluids and electrolytes must be maintained; and adequate energy should be
supplied for metabolic activities. Amount of blood loss, duration of NBM phase, metabolic stress,
climatic conditions; and renal & cardiac status must be taken into account.)
- Parenteral antibiotic therapy should be given (as indicated in a particular case.)
- Proper airway care should be taken. (Details given later in the text).
- Half-hourly monitoring of temperature, pulse and respiration should be done.
- 2-4 hourly B.P. record must be maintained.
- Input and output chart must be maintained and monitored. - Periodic examination of CVS, RS & C'NS
must be done.
- Post-operative soakage of blood and/or any other discharge
must be watched for.
- Tracheostomy tube care, whenever indicated, should be taken. (Details given later in the text.)
- Whenever intraoral surgical procedures are performed, RT feeding is given to avoid contamination of
the wound 'with food material.
- Whenever IMF (intermaxillary fixation) is done under G. A.., a cutter and a plier should be kept at the
bed side so that in the event of vomiting the wires can be cut, the mouth can be opened and intraoral
suction can be done to avoid the aspiration of vomitus into the trachea-bronchial
passage.
- Cleaning and dressing of the wound; antiseptic gargles; warns saline gargles; and removal of drains
inserted during the surgical procedure.
- Any other symptomatic treatment like administration of
anti-histaminics, sedatives, analgesics, antacids or anti-
inflammatory drugs; as indicated in a particular case;
should be given.
l4DRESSING TECHNIQUES:
Material used for dressing and cleaning the wounds or ulce'i upon the nature of the wound or ulcer .
Two persons are requ wear head caps and masks before; : put on sterile gl~ scrubbing; and do the
dressing with `no touch technique' i.e. aseptic care, The assistant is concerned with opening c dressing
and handing over the instruments or sterile dressin help of a cheatle forceps.
1. Clean Surgical wound (stitched). Clean with recti~ and dress with sterile dry gauze and cotton
pads.
2. Wounds with raw surface or ulcers not having disc cleaned with 1 % cetavlon or savlon; or 10/0
or (povidone-iodine) and are dressed with sterile Vasel which prevents disruption of delicate granulation
progressing epithelial edge.
3. Contaminated wounds are cleaned with 1 % cetavlo and dressed with an antiseptic dressing of
a.crifla.vi solution.), or mercurochrome (1:1000 solution); or iodine (5% solution).
4. Grossly infected wounds with a lot of discharge a are irrigated thoroughly with dissolving agents
likc H202, chlorhexidine gluconate, povidone-iodine ar saline are advised. In case of bony cavities which
.a open, the pack is changed daily after irrigation. T1 soaked in acriflavin and povidone-iodine.
DRAINS
MATERIAL USED: -
I . Corrugated rubber drain.
2. 'Tube rubber drain.
3. 'Tube polythene drain.
4. Suction/Vacuum drain.
IDEAL PROPERTIES OF DRAIN:-
1. It should be non-toxic and non-irritant.
2. It should be non-antigenic.
3. It should be non-absorbant and should facilitate free drainage of fluids along it. It should resist
enzymatic or hydrolytic degradation; and should maintain its integrity.
USES OF DRAIN:-
I. It helps in drainage of exudates, transudate and blood which accumulates in tissue dead space.
2. It helps in reducing the chances of excessive edema and haematoma, thus infection, pain and
discomfort.
BANDAGING:
A Bandage is a piece of material to cover, support, immobilize or exert pressure to a part of the body.
USES OF BANDAGE:-
1. As a first-aid measure for the injured, particularly to arrest bleeding.
2. To give rest and support to the part.
3. To retain dressing; and splint limb.
4. To prevent inflammatory edema.
BASIC DRESSING MATERIALS.
1 Gauze, gamgee.
2 Roller bandages (gauze)
3 Elastic bandages (elastocrepe).
4 Elastic adhesives (elastoplast)
BANDAGES IN ORAL AND MAX.ILLDFACIAL SURGERY:-
I Simple roller bandage-
a. Single headed. b. Double headed.
2 Barrel bandage for supporting lower jaw; and to retain dressings;
3. Four tail bandage for supporting the mandible.
4. Compression bandage with simple roller bandage, crepe bandage or with adhesive tapes or elastic
adhesive tapes
5. Mastoid bandage.
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