On discharge, a referral is usually made to the district nursing service who will visit the patient and assist with wound dressings and drain care.

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WOUND DRESSING

Depending on the type of surgery performed, the wound is dressed with steristrip and waterproof opsite dressing. The waterproof dressing can be removed after

5–7 days and the steristrip left on or replaced for another week. You are advised to keep the wound dry for the first 7 days.

Subsequently, you will be able to shower without the waterproof dressings and the wound gently pat dry with a soft towel. Soap and cream should be avoided on the wound in the first 4 weeks.

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DRAIN CARE

If a drain is inserted during surgery, you will often be discharged home with the drain. The district nursing service will provide wound and drain care in the community. The volume of drainage in the drain bottle over a 24 hour period is measured daily and recorded on a drainage chart.

The drain is removed by the district nurse if it drains less than 40ml/day or on Day 14 after surgery.

Once the drain is removed, it is not uncommon for the body to continue to produce fluid within the operative site. This collection of fluid is called a seroma. This is usually reabsorbed over time but if a large volume is produced, it may result in a visible swelling and can become uncomfortable. This usually requires needle aspiration which may be repeated as necessary (usually once a week or once every 2 weeks) until resolution of the collection. This is a fairly usual occurrence and is not urgent unless there is an underlying infection of the seroma. This infection is uncommon, but if it occurs, an urgent needle aspiration as well as antibiotics will be required.

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ARM EXERCISE

Once discharged, you are encouraged to gently mobilise and remain active. Gentle arm exercise is important, aiming for a full range of shoulder movement within 2 – 4 weeks after surgery. An information sheet with instructions on arm exercises will be given on discharge from hospital.