Hospital care (During)

The aim of this program is to improve the speed of recovery and discharge after surgery by encouraging the patient to mobilize and resume nutrition immediately after the surgical procedure to shorten the length of the hospital stay.

In practice, patients should agree and be motivated to:

• Take an energy-rich drink up to 2 hours before surgery.
• Restart nutrition on the day of surgery with fluids and biscuits.
• Mobilization on the day of surgery or at the latest the day after surgery.
• Prompt removal of Redons, drains, urinary catheter and perfusion.
• Discharge is possible even before the first bowel movement.

Pain relief:

• Postoperative pain management depends on the type of surgery (open abdomen, key hole surgery). In the immediate postoperative period, wounds may be injected directly with a local anesthetic.
• During the first 24 to 48 hours, paracetamol and anti-inflammatories can be administered intravenously or orally. Morphine derivatives can be administered intravenously, as well as by pump, intramuscularly or orally.

Antibiotics:

• 3 doses of antibiotics are administered during the first 24 hours:
  Antibiotics: Zinacef® / Flagyl®

• After the first 24 hours, antibiotics may be continued at the request of the surgeon.

Diet

• If possible, restart nutrition on the day with surgery with intake of fluids and biscuits.
• Afterwards, expand to a low-residue diet as soon as possible.

Mobilization

• Mobilization already on the day of surgery if possible.
• Day after surgery, at least mobilization to the chair.

Prevention of deep vein thrombosis

• Daily injection of Clexane® / heparin and wearing support stockings to prevent blood clots in the veins ( thrombosis). Blood clots can break loose and potentially clog up blood vessels in the lungs (pulmonary embolism). Pulmonary embolisms can be lethal.

Prevention of peptic ulcers

• During hospitalization, patients are administered drugs to reduce the increase of acid production in the stomach due to the stress after surgery. The antacids reduce the development of gastric ulcers and the risk of bleeding and perforation.

• A soft plastic drain (drainage tube) is placed near the anastomosis (suture) of the bowel (not systematically placed).
• Redon®: Drain that continuously aspirates tissue fluid, under the skin at the level of the wound (not systematically placed).
• Gastric tube: probe running down the nose into the stomach (not systematically placed).
• Urinary catheter will be removed as quickly as possible after the procedure.
• Infusion into the arm or neck (central venous catheter ) to administer fluids, analgesics, antibiotics and anti-emetics (to reduce nausea and vomiting).
• Pain pump with morphine (not systematically placed).
• If the right colon is removed through the vagina, a temporary gauze wick will be placed in the vagina.

• Discharge is planned when the patient can eat independently and mobilize autonomously. A bowel mouvement is not necessary before discharge.
• For patients who are not independent, it is important to contact the social service quickly, even before hospitalization, to organise home care or post-operative rehabilitation.

Social service contact details:

+32 2 614 92 92