11.1 INTRODUCTION

Postoperatively, patients must be monitored and assessed closely to ensure that they are fit to leave the clinic and that their condition does not deteriorate. The clinician needs to ensure that the appropriate postoperative care plan is implemented [1] (B).

Patients should be assessed prior to the surgery and their level of risk determined (B). Those that are at a higher risk of postoperative complications need a more robust and intense aftercare programme than those at a low risk. This should include having a tracking and early trigger mechanism in place to identify deteriorating patients (A).

The patients should be made as comfortable as possible during the healing phase. This involves having a thorough knowledge of postoperative pain and infection control. Patients must feel reassured and have a point of contact when they have been discharged. The patient needs to be given a comprehensive set of instructions so they know what to expect and how to care for themselves following surgery (B) (see Figure 11.1).

11.2 PAIN CONTROL

Consideration should be given to the immediate postoperative pain when choosing the duration of the local anaesthesia. It may be appropriate to use a longer lasting agent to make the patient more comfortable in the immediate postoperative healing phase.

The patient needs to be aware of the expected levels of pain and that the pain may be at its worse 2–3 days after the surgery. Furthermore, the patient needs to understand that a sudden increase in pain, or a constant pain that is not resolving, may indicate infection or complications and that they should contact the surgical team if they experience this (B).