A Patient's Guide to Heart Surgery
Taking Care of Your Incisions After Heart Surgery
After leaving the hospital, you will need to follow the advice of your healthcare team so that you can recover as quickly as possible. Depending on your surgery, your chest incision may extend through layers of skin, muscle and bone. Your skin should be healed by the time of discharge, your breastbone should take six to eight weeks, and your scar should fade in approximately six months to one year. Tingling, itching, and numbness are normal sensations associated with surgical wounds and will eventually disappear. During the first six months after surgery, protect your incisions from the sun by wearing a shirt or sun block. For women, wearing a soft bra to support your breasts will minimize incisional discomfort.
Types of Incisions
Traditional: In a traditional type of incision, strong sternal wires are used to close the breastbone. The chest is then closed with special internal or traditional external stitches.
Minimally Invasive: In a minimally invasive technique, smaller incisions are made that may or may not go through the sternum. Small incisions also may be made on the groin, leg or arm.
Other incisions may be present after surgery, from chest tubes, pacemaker wires or intravenous (IV) sites.
Taking Care of Your Incisions While Traveling
Going Home by Plane
When you are making flight reservations, let the airline know that you are recovering from surgery. If you had heart surgery, the sternal wires placed during surgery may set off the airport alarms. Because the distance may be too far to walk, ask for a wheelchair to take you to and from the plane. Once in the plane, stand up in the aisle and stretch your legs for a few minutes every hour to get your circulation going. If possible, also walk up and down the aisle.
Going Home by Car
When riding in a car, remember to stop every hour and walk 5 to 10 minutes to get your circulation going. You should wear your seatbelt, placing a small towel in between the seatbelt and your incision. If your car trip is longer than two hours, we recommend that you stay overnight in a hotel, get a good night's rest, then resume the next morning.
Taking a Shower or Bath
You may shower as usual using warm, rather than hot water. It is OK to let warm water run down over your incisions; however do not take a tub bath, soak in a Jacuzzi or go in a pool for approximately four weeks. Have someone help you get in and out of the shower until you regain your strength.
Consider using a shower stool if you feel weak or unsteady. Wash your incision gently every day with warm water and mild soap then pat dry with a soft towel. Do not apply lotion, powder, or ointments until the scab has fallen off (approximately 3-4 weeks). If you have paper strips on your incisions, they should peel off as you shower daily. If they don't, you may gently peel them off five days following discharge.
If the sutures are in your chest, shower with your back facing the water spray. If you cannot take a shower, a quick 10 minute bath is okay, but do not soak in the bathtub. Use only normal soap, not perfumed soap or body wash. Do not put the soap directly onto the incision and do not rub the incisions. Put soapy water on your hand or washcloth and gently wash your incisions. Only use a washcloth to rub when the scabs are gone and the skin is completely healed. After the shower or bath, dry yourself thoroughly. Pat your incisions dry, making sure not to rub them.
Signs of Incision Infection
It is important to look at your incisions periodically for signs of infection. Call your surgeon's office if you see any of these signs of infection:
Dealing with Discomfort
- increased drainage, swelling or oozing from incision
- opening of the incision line
- redness around the incision
- warmth along the incision line
- increased body temperature (greater than 101 degrees Fahrenheit or 38 degrees Centigrade)
Itching, tightness or numbness along your incisions is normal when you go home after surgery.
It is also normal to have muscle or incision discomfort in your chest if you are doing an activity. But you should not have the same pain that you had before surgery; if you do, let your doctor know. Also, if your sternum (breastbone) feels like it moves, pops or cracks when you move around, call your doctor.
If you had bypass surgery and saphenous vein grafts were taken, you also may have pain or discomfort in your legs from the incisions. To help ease this discomfort, try walking or doing activities that will move and stretch your legs.
Swelling in Your Legs and Feet
Removing a vein from your leg sometimes impairs the ability to return blood to the heart efficiently. The result is swelling in your feet and lower legs. If you have leg incisions, you should continue to wear your white support stockings given to you at the hospital. These should be worn as long as swelling persists during the day and removed in the evening before going to bed.To help alleviate the swelling:
- Prop your feet up when you are sitting or lying down, so that your feet are higher than your heart level. If you are sitting on the couch, put your feet up on a higher chair or ottoman. If you are lying down, put pillows under your legs and feet.
- Do not cross your legs.
- Even if your legs are swollen, walk daily to help circulation.
- Try using hospital support hose to cut down on the swelling.
If swelling persists or worsens, notify your doctor.
Listen to Your Body
You may be asked to do the following to help check on your healing. If so, do them as instructed by your health care provider.
- Weigh yourself daily and write down your weight.
- Take your pulse daily. Keep track of your results.
- Take your temperature daily to check for a fever.
- Watch for other signs of infection, such as a warm, oozing, or tender incision.