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Children’s Surgical Procedures

Children’s Surgical Procedures

Young boy in hospital bed

When your most precious treasure needs surgery, you want to know that your son or daughter is in the very best hands. The surgical teams at the Richland Hospital are among the very best at what they do. Children are every bit as precious to us as they are to you.

Led by highly skilled, compassionate surgeons, the Richland Hospital surgical teams score high in patient/ parent satisfaction and rank among the lowest in the country in infection rates.

Check out the sections below for more information specific to the many procedures we do right here in Richland Center.

Appendicitis

WHAT YOU NEED TO KNOW:

What is appendicitis?

Appendicitis is inflammation of the appendix. The appendix is a small pouch that is attached to the large intestine on the lower right side of the abdomen.

What causes appendicitis?

The appendix may get blocked by part of the bowel movement that becomes hard or by food. This can cause swelling and pain. The appendix can become infected with bacteria or a virus. Appendicitis can also be caused by a parasite, a tumor, or barium. Barium is a chemical that is used for certain imaging tests.

What are the signs and symptoms of appendicitis?

Symptoms may start suddenly. The most common symptom is pain that starts at the belly button and moves to the right, lower side of the abdomen. The pain worsens when your child touches his or her abdomen, moves, sneezes, coughs or takes a deep breath. Your child may also have one or more of the following signs and symptoms:

  • Abdomen that feels hard
  • Diarrhea or constipation
  • Loss of appetite
  • Nausea or vomiting
  • Fever that usually begins after other signs and symptoms

How is appendicitis diagnosed?

  • Blood tests: Your child may need blood taken to show if he or she has an infection. The blood may be taken from their hand, arm, or IV.
  • Urine test: Your child may need a urine test to check for a urinary tract infection or kidney stone.
  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of the abdomen. Your child may be given dye in his or her IV before the pictures are taken. The dye will help your child’s provider see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to some dyes.
  • Abdominal ultrasound: This test is done so caregivers can see the tissues and organs of your child’s abdomen. Gel will be put on the abdomen and a small sensor will be moved across the abdomen. The sensor uses sound waves to send pictures of the abdomen to a TV- like screen.

How is appendicitis treated?

  • Medicines:
    • Pain medicine: Your child may be given medicine to take away or decrease pain. Do not wait until the pain is severe before he or she takes the pain medicine.
    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    • Appendectomy: This is surgery to remove the appendix. During a laparoscopic appendectomy, small incisions are made in the abdomen. A small scope and special tools are inserted through these incisions. A scope is a flexible tube with a light and camera on the end. If the appendix has burst, your child may need an open appendectomy. This is when a single, larger incision is made to remove the appendix and clean out the abdomen.

What are the risks of appendicitis?

The appendix may burst. This can cause infected fluid to spread into the abdomen. If this happens, your child may have a high fever and severe pain. The infection can spread to the organs or blood. This can be life-threatening. Ask your caregiver for more information about the risks of appendicitis.

When should I contact my healthcare provider?

Contact your healthcare provider if:

  • Your child has abdominal pain that does not go away, even after taking medicine.
  • Your child has chills, a cough, or feels weak and achy.
  • Your child has trouble having a bowel movement or has diarrhea.
  • You have questions or concerns about your child’s condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your child has a fever.
  • Your child has severe pain in his or her abdomen.
  • Your child is vomiting and cannot keep food down.

 

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.


© 2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., or Truven Health Analytics.

Circumcision in Children

WHAT YOU NEED TO KNOW:

Circumcision is surgery to remove the foreskin of your child’s penis. The foreskin is the fold of skin that covers the tip of the penis.

Who needs a circumcision?

Specific benefits to circumcision include: reduced risk of urinary tract infections in the first year of life, and a lower risk for transmission of sexually transmitted infections, including HIV.

Circumcisions in the operating room.

If your baby does not meet the criteria for an office circumcision, it will need to be done under general anesthesia in the operating room. The surgery is done as an outpatient so your baby can go home the same day. During the circumcision in the operating room, a circular incision is made around your child’s penis. The foreskin is removed and the skin edges are sewn together with stitches. The stitches will dissolve so nothing has to be removed after surgery. A small dressing or Vaseline® is placed around your child’s penis as it heals.

AFTER YOU LEAVE THE HOSPITAL:

Medicines:

  • Give your child’s medicine as directed. Call your child’s healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child’s medicine list with you in case of an emergency.
  • Ibuprofen or acetaminophen: These medicines are given to decrease your child’s pain and fever. They can be bought without a doctor’s order. Ask how much medicine is safe to give your child, and how often to give it.
  • Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his healthcare provider. Do not stop giving your child the antibiotics unless directed by his healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness.

*Specific discharge instructions will be provided by your surgeon.

Wound care:

Follow your primary healthcare provider’s instructions on how to care for your child’s circumcision. If your child has a bandage on, ask when it can be removed. If a plastic ring was used, it should fall off 3 to 10 days after the procedure. Ask when your child can bathe.

Follow up with your child’s healthcare provider as directed: Write down your questions so you remember to ask them during your child’s visits.

Contact your child’s primary healthcare provider if:

  • Your child begins to vomit.
  • You have questions about your child’s procedure, condition, or care.

Seek care immediately if:

  • Your child’s incision is red, swollen, painful, or leaking pus.
  • Your child urinates very little or not at all.
  • Your child has a seizure.
  • Blood soaks through your child’s bandage.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse, or pharmacist before following any medical regimen to see if it is safe and effective for you.


©2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. Or Truven Health Analytics.

Hernia (Inguinal)

WHAT YOU NEED TO KNOW:

An inguinal hernia happens when a loop of intestine, fat, or tissue slips out of place inside your child’s abdomen. It looks like a bump or bulge under the skin near your child’s groin. Surgery is often needed to repair the hernia. A hernia may be serious if a loop of intestine becomes trapped or loses its blood supply.

What causes inguinal hernias in children?

  • Inguinal hernias usually happen because of a hole or a weak area in the muscles of your child’s abdominal wall. They may also happen when part of an organ, intestine, or tissue from the abdomen falls into the inguinal canal. The inguinal canal is a tube-shaped passage that goes through the wall of the lower abdomen. In boys, this passage allows the testicles to drop in to the scrotum before birth. In girls, this passage contains tissue that helps hold the uterus in place. A hernia can happen if this passage does not close as it should.
  • Hernias are more common in premature infants. A child has a greater chance for a hernia if someone in your child’s family had an inguinal hernia. Certain health problems, such as cystic fibrosis or undescended testicles, increase the risk that your child may have a hernia.

What are the signs and symptoms of an inguinal hernia in children?

  • Your child has a bulge or lump in his groin or lower abdominal area.
  • The lump may get bigger when your child cries, coughs, or strains to have a bowel movement. It may get smaller or go away when your child is relaxed.
  • Your son may have a lump or swelling in his scrotum.

How is an inguinal hernia diagnosed?

Your child’s healthcare provider can usually tell if he or she has a hernia during an exam. The healthcare provider may check to see if the hernia can be reduced (gently pushed back into the abdomen). Your child may need tests, such as x-rays of the abdomen or an ultrasound. These tests will help healthcare providers decide how to treat your child’s hernia.

How is an inguinal hernia treated?

Treatment depends on the type of hernia your child has, your child’s age, and his or her overall health. Inguinal hernias often need to be fixed with surgery. Without surgery, hernias often get worse over time. Your child may need surgery right away if a loop of intestine has become trapped in the hernia.

What are the risks of an inguinal hernia?

A loop of intestine could become stuck in the hernia. This can cause your child’s intestines to become blocked. The blood flow to the loop of intestine in the hernia could become cut off. This could cause that part of the intestine to die. This can be life-threatening.

When should I contact my child’s healthcare provider?

  • Your child is crying more than normal, or seems to be in pain.
  • Your child is vomiting.
  • You cannot gently push your child’s hernia back into his or her abdomen. (Do this only if a healthcare provider has shown you how to do it.)
  • Your child has trouble having a bowel movement.
  • Your child’s abdomen seems larger, rounder, or more full than normal.
  • Your child’s hernia is getting bigger, or the skin over the hernia becomes swollen or red.
  • You have questions or concerns about your child’s condition or care.

When should I seek immediate care?

  • Your child has a fever.
  • Your child’s hernia is stuck outside the abdomen and is painful, swollen, or feels hard.
  • Your child stops having bowel movements and stops passing gas.
  • Your child has blood in his or her bowel movement.
  • Your child’s abdominal pain is bad or getting worse.

 

AFTER YOU LEAVE THE HOSPITAL:

Medicines:

  • Give your child’s medicine as directed. Call your child’s healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child’s medicine list with you in case of an emergency.
  • Acetaminophen decreases pain and fever. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he or she takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child’s medicine labels for Aspirin, Salicylates, or oil of wintergreen.
    *Specific discharge instructions will be provided by your surgeon.
     

Follow up with your child’s healthcare provider as directed: Write down your questions so you remember to ask them during your visits.

 

CARE AGREEMENT:

You have the right to help plan your child’s care. Learn about your child’s health condition and how it may be treated. Discuss treatment options with your child’s caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.


© 2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

Hernia (Umbilical) in Children

WHAT YOU NEED TO KNOW:

What is an umbilical hernia?

An umbilical hernia is a bulge through the abdominal wall in the area of your child’s umbilicus (belly button). The hernia may contain fluid, tissue from the abdomen, or part of an organ (such as an intestine). Children that are born prematurely, have a low birth weight, or are African-American, may be at an increased risk for an umbilical hernia.

What causes an umbilical hernia?

  • An opening in the abdominal wall that does not close at birth
  • Weakness in the abdominal wall

What are the signs and symptoms of an umbilical hernia?

Umbilical hernias usually do not cause any pain. It may disappear when your child is relaxed and lying flat.

  • A bulge or swelling in the area of your child’s navel
  • A bulge that gets bigger when your child cries, coughs, strains to have a bowel movement, or sits up
  • Vomiting
  • Constipation
  • Irritability or poor feeding

How is an umbilical hernia diagnosed?

Your child’s healthcare provider will examine your child and feel his or her abdomen. This is often all that is needed to diagnose the hernia. An ultrasound may be needed in rare cases when the diagnosis is hard to make by exam alone. An ultrasound may show the tissue or organ that is contained within the hernia.

How is an umbilical hernia in children treated?

Many umbilical hernias in children will close on their own by age 4 to 5 and do not need treatment. Your child’s healthcare provider may be able to manually reduce the hernia by putting firm, steady pressure on your child’s hernia until it disappears behind the abdominal wall. Your child may need surgery to fix his or her hernia if it does not go away on its own by age 4 to 5, or causes complications. Complications of a hernia happen when the hernia stops blood flow to an organ that is caught inside. The hernia can also block your child’s intestines.

How can I manage my child’s umbilical hernia?

  • Give your child liquids as directed. Liquids may prevent constipation and straining during a bowel movement. Ask how much liquid to give your child each day and which liquids are best.
  • Feed your child foods that are high in fiber. Fiber may prevent constipation and straining during a bowel movement. Foods that contain fiber include fruits, vegetables, whole grains, and legumes such as peas, beans, and peanuts.
  • Do not place anything over your child’s umbilical hernia. Do not place tape or a coin over the hernia. This may harm your child.

When should I seek immediate care?

  • Your child’s hernia gets bigger, is firm, or is blue or purple.
  • Your child’s abdomen seems larger, rounder, or more full than normal.
  • Your child stops having bowel movements and stops passing gas.
  • Your child has blood in his or her bowel movement.
  • Your child is crying more than normal, or he or she seems to be in pain.

When should I contact my child’s healthcare provider?

  • Your child has a fever.
  • Your child is vomiting.
  • Your child has trouble having a bowel movement.
  • You have questions about your child’s condition or care.

 

AFTER YOU LEAVE THE HOSPITAL:

  • Give your child’s medicine as directed. Call your child’s healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child’s medicine list with you in case of an emergency.
  • Acetaminophen decreases pain and fever. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he or she takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child’s medicine labels for Aspirin, Salicylates, or oil of wintergreen.

*Specific discharge instructions will be provided by your surgeon.

Follow up with your child’s healthcare provider as directed: Write down your questions so you remember to ask during your visits.

 

CARE AGREEMENT:

You have the right to help plan your child’s care. Learn about your child’s health condition and how it may be treated. Discuss treatment options with your child’s caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.


© 2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

Lymph Node Biopsy

WHAT YOU NEED TO KNOW:

What do I need to know about a lymph node biopsy?

A lymph node biopsy is done to remove all or part of a lymph node. A group of lymph nodes may also be removed.

Why might my child need a lymph node biopsy?

  • To find out the cause of enlarged lymph nodes
  • To find the cause of recurrent fevers, night sweats, or weight loss
  • To stage cancer (see if it has spread to lymph nodes)
  • To remove cancer

How do I prepare my child for a lymph node biopsy?

Your healthcare provider will talk to you about how to prepare your child for the procedure. Your healthcare provider will tell you what medicines to take or not take and when to stop eating or drinking before surgery.

What will happen during a lymph node biopsy?

Your child will be given medicine to numb the area to keep him or her asleep and pain-free during the procedure. The type of anesthesia will depend on the type of biopsy the child is having. The child may be having:

  • Needle biopsy: Your healthcare provider will numb the area near the lymph node. He will stick a needle into the lymph node and pull out some cells. He will remove the needle and put a bandage on the area.
  • Open biopsy: A small incision is made and your healthcare provider removes part or all of the lymph node. He stitches the incision closed and puts a bandage over it.
  • Sentinel node biopsy: This biopsy is done to see if the cancer has spread. Your healthcare provider will inject a blue dye or tracer near the cancer site. He will remove the lymph node that the dye or tracer identify is closest to the cancer site. The lab will check for cancer cells within the lymph node.

What are the risks of a lymph node biopsy?

There is a risk of infection at the biopsy site. Your child may have swelling (lymphedema) if a group of lymph nodes are removed. This swelling may be recurrent for the rest of his or her life. Your child may have nerve damage in the biopsy area. The diagnosis may not be clear and your child may need more tests.

AFTER YOU LEAVE THE HOSPITAL:

Wound care for the biopsy site:

Keep the wound clean and dry. Your child may not be able to take a shower or bath for up to 2 days. Ask your healthcare provider when your child can take a shower or bath.

Contact your healthcare provider if:

  • Your child has a fever or chills.
  • Your child has swelling, severe pain, and redness at his or her biopsy site.
  • Your child has bleeding or drainage from his or her biopsy site.
  • You have questions or concerns about his or her condition or care.

*Specific discharge instructions will be provided by your surgeon.

Follow up with your healthcare provider as directed:

Your child may need more tests. Write down your questions so you remember to ask them during visits.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.


© 2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., or Truven Health Analytics.

Orchiopexy for Undescended Testicle

WHAT YOU NEED TO KNOW:

Orchiopexy is surgery to move one or both of your child’s undescended testicles from his lower abdomen in his scrotum.

After your son receives general anesthesia, the surgeon will make an incision in his groin area, and locate the undescended testicle, which is usually in the inguinal canal above the scrotum. The surgeon will then make a small incision into the scrotum, pull the testicle down, place it in a small pouch in the scrotum and attach it with stitches. The incision will be covered with a small strip of tape, then gauze and a clear bandage. After your son recovers from the anesthesia and surgery, he may go home.

AFTER YOU LEAVE THE HOSPITAL:

Medicines:

  • Give your child’s medicine as directed. Call your child’s healthcare provider if you think the medicine is not working as expected. Tell him if our child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child’s medicine list with you in case of an emergency.
  • Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his healthcare provider. Do not stop giving your child the antibiotics unless directed by his healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness.
  • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child’s medicine labels for aspirin, salicylates, or oil of wintergreen.

Activity:

Let your child rest and sleep as much as he wants. He should not use toys that must be straddled, like a tricycle or toy horse, for 2 weeks. Your child may return to normal activity when he feels ready.

Ice:

Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your child’s incision or between his legs for 15 to 20 minutes every hour as directed.

*Specific discharge instructions will be provided by your surgeon.

Follow up with your child’s primary healthcare provider as directed:

Your child may need an ultrasound test so caregivers can check the condition of his testicles. Write down your questions so you remember to ask them during your visits.

Contact your child’s primary healthcare provider if:

  • Your child has a fever.
  • Your child has chills, a cough, or feels weak and achy.
  • Your child is vomiting or urinating less than usual.
  • Your child is irritable and crying more than usual.
  • You have questions or concerns about your child’s condition or care.

Seek care immediately if:

  • Blood soaks through your child’s bandage.
  • Your child’s wound or bandage has pus or a bad smell.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse, or pharmacist before following any medical regimen to see if it is safe and effective for you.


©2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. Or Truven Health Analytics.

Tonsillectomy and Adenoidectomy

tonsils-illustration

WHAT YOU NEED TO KNOW:

A tonsillectomy is surgery to remove your child’s tonsils. Tonsils are two large lumps of tissue in the back of your child’s throat. Adenoids are small lumps of tissue on the top of the throat. Tonsils and adenoids both fight infection. Your child may need his or her tonsils removed to improve breathing or to reduce throat, sinus, and ear infections. The adenoids may be taken out at the same time if they are large or infected.

How should my child prepare for a tonsillectomy?

Your healthcare provider will talk to you about how to prepare for your child’s surgery. He will say when your child should stop eating and drinking before surgery. He will tell you what medicines your child should or should not take on the day of surgery.

What will happen during a tonsillectomy?

Your child will be given general anesthesia to keep him asleep and free from pain during surgery. Your child may be given medicine before the surgery to help him or her relax. The surgeon will place tools inside your child’s mouth to keep it open. He will then cut all or part of the tonsils away from surrounding tissue. The surgeon will stop any bleeding from the areas where the tonsils were removed.

What will happen after a tonsillectomy?

Your child may need to stay in the hospital if younger than 3 years old. Your child may also need to stay overnight if he or she has breathing or other health problems. Your child will have throat pain that may last up to 2 weeks. Throat pain will be worse in the morning. This pain may spread to the ears. It may hurt for your child to swallow, and he or she may not feel like eating or drinking however your child will need to drink plenty of fluids to prevent dehydration. Your child will have white patches in the back of the throat. These are scabs that will fall off after about a week.

What are the risks of a tonsillectomy?

Your child may bleed more than expected during or after surgery, or get an infection. Your child may also have swelling in the mouth, throat, or lungs that makes it hard to breathe. Your child may have nausea and vomiting after surgery. Your child may have changes in his or her voice or sense of taste after surgery. Tools used to remove your child’s tonsils may cause injury to the teeth, voice box or roof of the mouth. Tools that use heat to remove the tonsils can cause a burn. Your child’s tonsils could grow back after surgery.

AFTER YOU LEAVE THE HOSPITAL

Give your child’s medication as directed.

  • Call your child’s healthcare provider if you think the medicine is not working as expected. Tell your provider if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child’s medicine list with you in case of an emergency.
  • Acetaminophen: This medicine decreases pain and fever. You can buy acetaminophen without a doctor’s order. Ask how much and how often to give it to your child. Follow the directions. Acetaminophen can cause liver damage if not taken correctly.
  • Pain medicine: Your child may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you give more pain medicine.
  • Antibiotics: This medicine may be used to help prevent or fight an infection caused by bacteria. Give this to your child as directed.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he or she takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child’s medicine labels for Aspirin, Salicylate, or oil of wintergreen.

What to expect after surgery:

  • Pain and swelling: Your child’s face, throat, and neck may be swollen or tender for up to 2 weeks after surgery. Pain may be worse in the morning.
  • Mild fever: Your child may have a low fever while the tonsil areas heal. Give liquids often to help reduce it.
  • Bleeding: A small amount of bleeding is normal within 24 hours after surgery. Bleeding can also happen 5-10 days after surgery when the scabs fall off, or if your child has an infection. Ask how much bleeding to expect. Encourage your child not to cough or clear his or her throat as this may cause or increase bleeding.

Mouth care:

It is normal for your child to have throat pain and bad breath after surgery. Help your child with the following:

  • Gently rinse your child’s mouth as directed to remove blood and mucus.
  • Help your child gently brush his or her teeth. Do not let your child gargle or brush teeth too hard. This can cause bleeding.

Food and Drink:

  • Give your child plenty of liquids: This will help prevent fluid loss, keep his or her temperature down, decrease pain, and speed healing. Liquids and foods that are cool or cold, such as water, apple or grape juice, popsicles, and gelatin, will help decrease pain and swelling. Do not give him orange juice or grapefruit juice. This may bother your child’s throat.
  • Give your child soft foods: Do this once your child can drink liquids easily and his or her stomach is not upset. Examples are applesauce, oatmeal, soft-boiled eggs, macaroni, and ice cream. Once your child can eat soft food easily, he or she may slowly begin to eat solid foods. Do not give your child anything spicy, hot, or with sharp edges, such as chips. These can hurt the tonsil areas.
  • Do not give your child hot foods or drinks: Do not give your child hot tea, soup, or any other hot or warm foods or drinks. They can increase the risk for bleeding. Do not give your child milk and dairy foods if your child has problems with thick mucus in his or her throat. This can cause your child to cough, which could hurt the surgery areas.

Caring for your child after surgery:

  • Let your child rest: Your child will need to rest and limit activity for 7-10 days after surgery or as directed.
  • Use ice on your child’s throat: Ice helps decrease swelling and pain. Use an ice pack or put crushed ice in a plastic bag. Cover the ice pack with a towel and place it on your child’s throat for 15-20 minutes every hour for 2 days.
  • Use a cool humidifier: This will help moisten the air and sooth your child’s throat.
  • Gently wash your child’s neck: Bathe your child as you normally would, or have your child bathe him or herself with care. The throat and neck area may be sore. Ask if you need to use cool water to wash your child’s neck until it heals.
  • Do not smoke around your child: Keep your child away from smoky areas. Smoke may cause the throat to bleed.
  • Keep your child away from people with colds, sore throats, or the flu: Your child may get sick more easily after surgery.

Contact your child’s surgeon or primary healthcare provider if:

  • Your child has a fever.
  • Your child has throat pain or an earache that is worse than expected.
  • Your child has itchy skin or a rash.
  • You have any questions or concerns about your child’s care.

Seek care immediately if:

  • Your child has bright red bleeding from the throat, nose, or mouth, or bleeding worsens.
  • Your child feels weak, dizzy, or like he or she will faint when sitting up or standing.
  • Your child has severe throat pain with drooling or voice changes.
  • Your child has a stiff and painful neck.
  • Your child has a sudden swelling or pain in the face or neck.
  • Your child has back or chest pain.
  • Your child has trouble breathing or swallowing.
  • Your child is unable to eat or drink.

Follow up with your child’s healthcare provider as directed: Write down your questions so you remember to ask them during your child’s visit.

For more information on how to prepare your child, read the information on the Surgery and Your Child page of our website.

Read one patient’s tonsillectomy and adenoidectomy story.

Wrist Fracture in Children

WHAT YOU NEED TO KNOW:

What is a wrist fracture?

A wrist fracture is a break in one or more of the bones in your child’s wrist.

What causes a wrist facture?

A wrist fracture is usually caused by a fall on an outstretched hand. Your child’s wrist may also be broken while he or she plays sports. Wrist bones may also be broken when hit by a hard object.

What are the signs and symptoms of a wrist fracture?

  • Pain, swelling, and bruising of the injured wrist
  • Wrist pain that is worse when your child holds or squeezes something
  • Weakness, numbness, or tingling in the injured hand or wrist
  • Trouble moving the wrist, hand, or fingers
  • Change in the shape of your child’s wrist

How is a wrist fracture diagnosed?

  • X-rays: Your child may need x-rays of the wrist, hand, and forearm to check for broken bones or other problems. X-rays of both your child’s injured and uninjured wrists may be taken.
  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your child’s forearm, wrist, and hand. The pictures may show if your child has broken a bone. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if your child has ever had an allergic reaction to contrast dye.
  • MRI: This scan uses powerful magnets and a computer to take pictures of your child’s forearm, wrist, and hand. An MRI may show if your child has broken a bone. Your child may be given a dye to help the pictures show up better. Tell the caregiver if your child has ever had an allergic reaction to contrast dye. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if your child has any metal in or on his or her body.

How is a wrist facture treated?

Treatment will depend on which wrist bone was broken and the kind of fracture your child has. Your child may need the following:

  • Cast or splint: A cast or splint will keep your child’s wrist from moving to allow it to heal. They may be used to decrease pain and prevent pain and prevent further damage to the broken bones.
  • Medicine: Caregivers may give your child medicine to help ease pain. Your child may need antibiotic medicine or a tetanus shot if there is a break in his or her skin.
  • Surgery: A wrist fracture that is severe or does not heal with other treatments may need surgery. If a bone has moved out of place, your child may need surgery to put it back in its normal position. A surgeon may also do surgery to place a bone graft into spaces between or around the fracture.

What are the risks of a wrist fracture?

Surgery or an open wound may cause your child to bleed or get an infection. If not treated, the bones may not heal properly. The injured wrist may become stiff or deformed. Your child may have problems with hand movement or grip strength. It may also cause decreased blood supply to the wrist and hand.

AFTER YOU LEAVE THE HOSPITAL:

Medicines:

  • Give your child’s medicine as directed. Call your child’s healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child’s medicine list with you in case of an emergency.
  • Pain medicine: Your child may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you give your child this medicine.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome is he or she takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child’s medicine labels for aspirin, salicylates, or oil of wintergreen.

*Specific discharge instructions will be provided by your surgeon.

Follow up with your child’s primary healthcare provider or bone specialist as directed:

Write down any questions so you remember to ask them in your follow-up visits.

Your child may need more rest than he or she realizes while healing.

Quiet play will keep your child safely busy so he or she does not become restless and risk injuring themselves. Have your child read or draw quietly. Follow instructions for how much rest your child should get while he or she heals.

Ice:

Ice helps decrease swelling and pain. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on your child’s fractured wrist for 15 to 20 minutes every hour as directed.

Care for your child:

  • Check the skin around your child’s cast or splint daily for any redness or sores.
  • If your child’s splint is too tight, his or her fingers may be numb or tingle. Gently loosen the fasteners as directed to relieve the tightness.
  • Do not let your child use a sharp or pointed object to scratch the skin under the cast or splint.
  • Tell your child not to push down or lean on any part of the cast or splint, because it may break.

How to bathe with a cast or splint:

Before your child bathes, cover the cast or splint with a plastic bag. Tape the bag to the skin above your child’s cast or splint to keep out water. Have your child hold his or her arm away from the water in case the bag leaks. It is important that your child does not get the cast or splint wet.

Physical therapy:

Your child may need physical therapy after his or her wrist has healed and the cast is removed. A physical therapist can teach your child exercises to help improve movement and strength and to decrease pain.

Contact your child’s primary healthcare provider or bone specialist if:

  • Your child has a fever.
  • There is a foul smell coming from under the cast.
  • Your child has more pain or swelling than he or she did before the cast or splint was put on.
  • You have questions or concerns about your child’s condition or care.

Seek immediate care if:

  • Your child has increased pain that does not go away.
  • Your child’s cast breaks or is damaged.
  • Your child’s arm or hand feels numb.
  • Your child’s fingers on the injured wrist turn blue or white, or they are cold or numb.
  • Your child’s splint or cast is too tight.
  •  

    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse, or pharmacist before following any medical regimen to see if it is safe and effective for you.


    ©2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistruted or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

    ORIF of a Wrist Fracture

    WHAT YOU NEED TO KNOW:

    What do I need to know about open reduction and internal fixation (ORIF) of a wrist fracture?

    ORIF of a wrist fracture is surgery to fix a broken wrist. Medical plates, screws, pins, or wires will be used to hold the bones in place while they heal.

    How do I prepare my child for surgery?

    Your healthcare provider will talk to you about how to prepare for surgery. He will tell you what medicines to take or not take on the day of surgery. You will be instructed on when to stop eating and drinking before the surgery.

    What will happen during surgery?

    General anesthesia is typically used to keep your child free from pain during surgery. Your surgeon will make one or more incisions on his or her wrist. He will use medical plates, screws, pins, or wires to hold the broken bones together. A bone graft may be placed in or around the fracture to strengthen the wrist. X-rays may be taken during surgery to make sure the broken bone is set properly. X-rays also show if the pins, plates, and screws are placed correctly. Your surgeon will close the incision with stitches or staples. A splint will be placed over his or her wrist to keep the bones in place while they heal.

    What are the risks of surgery?

    Your child may bleed more than expected or get an infection. Tendons and nerves may get injured during or after surgery. The wrist may not heal properly. He or she may continue to have wrist pain.

    AFTER YOU LEAVE THE HOSPITAL:

    Medicines:

    • Take your medicine as directed. Call your healthcare provider if you think the medicine is not helping or if he or she has any side effects. Tell him if your child is allergic to any medicine. Keep a list of the medicines, vitamins, and herbs he or she takes. Include the amounts, and when and why he or she takes them. Bring the list or the pill bottles to follow-up visits. Carry your child’s medicine list with you in case of an emergency.
    • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely.

    *Specific discharge instructions will be provided by your surgeon.

    Your child will need to return to have his or her wound checked and stitches or staples removed. Write down your questions so you remember to ask them during the visits.

    Self-Care:

    • Apply ice on to wrist for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
    • Elevate the wrist above the level of the heart as often as possible. This will help decrease swelling and pain. Prop the wrist on pillows or blankets to keep it elevated comfortably.
    • Care for the splint or cast as directed. Ask when your child can bathe. Follow your healthcare provider’s directions for bathing with a splint or cast.
    • Ask when your child can return to normal daily activities. Your healthcare provider may recommend that your child exercise the fingers and arm.

    Contact your healthcare provider if:

    • Your child has a fever.
    • You have questions or concerns about his or her condition or care.

    Seek care immediately if:

    • Your child is having severe pain, even after taking pain medicine.
    • The incision is red, swollen, or draining pus.
    • The fingers look pale or blue, feel numb, or tingle.
    • Blood soaks through the bandage.
    • The cast or splint breaks or gets damaged.

    CARE AGREEMENT:

    You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.


    © 2015 Truven Health Analytics Inc. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., or Truven Health Analytics.