Care of Your Child's Incision

If your incision has Dermabond (“glue”):

• Keep incision dry. If it gets dirty, lightly clean with mild soap and water and pat dry.
• May shower with back to shower stream. No forward facing showers / direct contact of shower stream for four weeks after surgery.
• No tub bath or swimming in pools, hot tubs, lakes, oceans or rivers for four weeks after surgery.
• Derma-bond falls off in about two weeks.
• After glue falls off, continue to clean incision daily with soap and water and pat dry.

If your incision has Steri-Strips (white tapes):

• Gently clean incision daily with soap and water and pat dry.
• May shower with back to shower stream. No forward facing showers/direct contact of shower stream for four weeks after surgery.
• No tub bath or swimming in pool for four weeks after surgery.
• Steri-Strips fall off in about two weeks. If they do not fall off on their own, it is OK to remove them after your follow up with cardiology. If steri-strips gets contaminated (dirt, emesis, sweat, etc), it is OK to remove prior to cardiology appointment.
• After Steri-Strips fall off, continue to clean incision with soap and water and pat dry.

No creams, oils or ointments should be applied to incision for four weeks after surgery.

The sutures at the top and bottom of your child’s incision will be removed at their first cardiology follow up appointment approximately two weeks following discharge. If you have any further questions regarding your child’s incisional care, please have your provider contact cardiac surgery at the time of this appointment.

Your chest tube sites might have sutures in place. These sutures will often dissolve/fall off on their own six-eight weeks after the chest tubes are removed. Clean old chest tube sites with mild soap and water and pat dry.

The healing skin is more sensitive to sun damage than normal skin. Clothing or a high SPF sun block should protect your child's incision when sun exposure cannot be avoided.

Check the incision daily for signs of infection: redness, swelling, drainage, or fever above 100 degrees Fahrenheit. Call your child's cardiology office if any of these signs are noted.

Diet After Heart Surgery

Infants

Your baby can take as much formula as he wants unless otherwise instructed. He may need extra calories because his heart may be working harder than most babies. If your baby needs a high-calorie formula, you will be given a recipe for the formula before going home. Limit feeding time to 30 minutes so your baby doesn't become overtired.

Toddlers, School-Aged Children, Adolescents and Adults

Follow a regular diet unless otherwise instructed. Encourage a balanced diet of foods that promote healing: meats, milk, bread products, fruits and vegetables. Call your doctor if unable to eat, vomiting or weight loss.

Activity After Heart Surgery

Infants

Lift your infant by supporting his head and bottom with your hands for four weeks after surgery. Try to limit lifting them from beneath their arms for four weeks after surgery.

Toddlers, Preschoolers and School-Age Children

• Most children will limit their own activity when tired.
• Encourage your child to play or walk; inactivity is discouraged.
• No activity that will put your child at risk of a direct blow to the chest. No climbing, riding bicycles, roller skating, in-line skating, contact sports or gym class for four weeks after surgery.
• Avoid lifting over 10 pounds.
• Climbing steps is not a problem.
• May return to school in two to six weeks. Discuss timing with your child's cardiologist.

Adolescents and Adults

• Return to work in six weeks, unless otherwise directed.
• No driving for four weeks after surgery – must be off all narcotic pain medication before resuming driving.
• No activity that will put you at risk of a blow to the chest incision. No climbing, riding bicycles, roller skating, in-line skating or contact sports for four weeks after surgery.
• May walk; take rests when tired.
• Climbing steps is not a problem.
• Avoid lifting over 10 pounds for four weeks after surgery.
• Avoid smoking.

Common Behaviors After Heart Surgery

Due to your child's hospitalization and surgery, it is not unusual for him to go back to earlier childhood behaviors such as: bedwetting, awakening during the night, fussiness, nightmares, clinging to parents, etc.

These behaviors usually go away within a short period of time. It is important to support your child during this stressful time but also to set appropriate limits.

School and Day Care After Heart Surgery

Your child should not attend school or day care until being cleared by the cardiologist.

Immunizations After Heart Surgery

Children should not receive most immunizations for at least four weeks after surgery. If your child has received blood products while hospitalized, a longer wait may be necessary.

Dental Care After Heart Surgery

Be sure to talk to your dentist and cardiologist regarding your child's dental care. Some children with heart defects require antibiotics before and after dental procedures to prevent infection. Good dental hygiene and regular visits to the dentist are important since tooth decay can lead to heart infection.

Call Your Child's Doctor If:

The cardiology team is available 24 hours a day at 513-636-4200 or 1-800-344-CHMC.

During the six weeks after surgery, call if your child has two or more of the following:

• Rapid, heavy breathing
• Excessive sweating
• Extreme sleepiness
• Unable to drink bottle for two feedings in a row
• Puffiness of the eyes or face
• Extreme irritability
• Blueness of the skin

During the six weeks after surgery, call if your child has either of the following:

• Fever above 100 degrees Fahrenheit
• Drainage from incision or incision red and swollen

Important Contact Numbers

• Cardiothoracic Surgery Office: 513-636-4770
  Office hours 8:30 am-5 pm; voicemail after hours.
• If wound concerns, please direct them to the Cardiothoracic Surgery Wound Phone: 513-429-8130. A team member carries this phone 6:00 am to 6:00 pm Monday-Friday. Please call the main hospital if more urgent concerns arise.
• Hospital operator (5 pm-8:30 am): 513-636-4200 or 1-800-344-CHMC
  Ask for cardiology fellow on call.
• Cardiology Clinic: 513-636-4432
  Hours 8:30 am-5 pm; voicemail after hours.