Endovascular Abdominal Aortic Aneurysm Care at Home
This handout will tell you how to take care of yourself at home after your endovascular abdominal aortic aneurysm (AAA) repair. Your nurse will review this sheet with you before you go home. If you have more questions once you are home, you may call PVS clinic at(608) 263-8915. To reach a doctor after hours, call hospital paging (608) 262-0486 and ask for the PVS resident on call. Give paging your name and phone number with the area code. The doctor will call you back. If you live out of the area, call 1-800-323-8942.
Care of the Incision
There are several layers of stitches holding your wound together on the inside. By the time you go home, your skin is usually closed on the outside with staples. At your first clinic visit, your staples may be removed and small pieces of tape called Steri-Strips® may be placed along the incision to help support it for a few days. You may get the staples wet in the shower, but do not swim or take tub baths. Clean the area gently with mild soap and water removing any dried drainage. It is very important to keep groin incisions dry. Moisture in the groin can lead to infection. Ask your nurse for tips on how you can avoid problems with infection.
You may also shower with the Steri-Strips® in place, but do not soak them for any length of time. Also, do not rub the incision; just allow the water to flow gently over the area. When done in the shower, take extra care to be sure the incision is dry. After 2-3 days, as your wound heals, the Steri-Strips® will begin to curl up at the ends. You may trim the curled ends with a scissors. In time the Steri-Strips® will fall off on their own. If they do not, then you can remove them after one week.
When to Call Your Doctor
Twice each day you should look at your incision for signs of infection or breakdown. Please call your doctor if you have:
- An increase in redness or warmth at the site of the incision or red streaks on your skin that extend from the site where the stitches are.
- Bulging or swelling at the incision.
- New drainage or bleeding from your incision, or open spots between the stitches where the skin is pulling apart.
- A temperature of more than 101.5° F (38.5°C) by mouth for two readings taken 4 hours apart.
- If you notice the skin along the incision is getting darker or turning black.
Activity
At the time of discharge you should have resumed a number of your basic daily routines, but you will still need to allow yourself time for rest. You may feel weaker and notice that you tire more quickly than before. This is NORMAL. It may take 6 to 8 weeks for you to feel like yourself again. Your strength and energy level will increase as your body recovers. Your sleeping pattern should return to normal, as you heal. Walking is good for you, but it is important that you start slowly and increase your distance a little bit each day.
There are some things that you should avoid in the first few weeks after surgery. These include:
- Do not lift more than 5-10 pounds during the first 2 weeks at home. One gallon of milk is about 8 pounds.
- Do not drive until your doctor says it is okay, usually not until after the first clinic visit.
- Do not play contact sports or engage in exercise other than walking unless your doctor approves.
- Ask your doctor at your follow-up visit when you may return to work and resume sexual activity.
Pain Control
It is normal to have some pain in the suture lines after surgery. Your doctor has prescribed pain medicine for you to use at home. This is often the same medicine you have been getting here. As healing occurs, comfort along the incision improves and you will need less for pain. Your pain may be relieved with an over-the-counter pain reliever. Consult your doctor before starting.
Diet
It is common after surgery to have a decreased appetite and some weight loss. Even if your appetite is poor, you should try to eat well to promote healing. Often small amounts of food eaten often work better than three large meals a day.
The number one problem patients have after discharge is not getting enough fluids. This can increase your fatigue and weakness and slow your healing. It is very important to follow the guidelines below.
- Drink at least 8-10 (8 oz) glasses of water or fruit juices per day. Caffeine-containing drinks deplete your body of fluids and are not the best choice for meeting your fluid needs.
- Eat at least three fiber-rich foods each day. Foods rich in fiber include most fruits and vegetables (especially apples, dates, beans and peas) and whole grain breads and cereals (especially bran products and oatmeal).
- Try eating prunes or drinking prune juice.
Antibiotics
Because you now have an aortic graft, you will need to tell your dentist before you have any dental work done. Your dentist will order prophylactic antibiotics for you to take before your appointment. We suggest 2 grams of amoxicillan or 600 mg of clindamycin by mouth if allergic to penicillin one hour before the procedure as recommended in Circulation 1997;96:358. Please renal dose all medications.
Also remember to inform your doctor of your aortic graft before planning any surgeries/procedures or interventions to determine the need for prophylaxis.
Are You at Risk for Poor Blood Flow to the Legs and Feet?
You are more likely to have poor blood flow to the legs if you:
- Smoke
- Have high blood pressure
- Have high cholesterol
- Have diabetes
- Are over age 50
- Do not exercise
- Have heart disease in your family
How Do I take Care of Legs and Feet with Poor Blood Flow?
- Look at legs and feet daily for sores, scratches, cracks blisters or reddened areas. Report them to your doctor or nurse.
- Wash your legs and feet daily with mild soap and water. Avoid soaking. Dry well.
- Put lotion on dry skin daily.
- Let a doctor or nurse clip your toenails or show you how to clip toenails.
- Wear shoes that fit well.
- Wear white cotton or wool socks.
- Check shoes and socks for stones, sharp things, or holes.
- Do not use heating pads or hot water bottles on legs or feet.
- Never go barefoot.
References
Fahey, Victoria A. 3rd ed. Vascular Nursing. Philadelphia: WB Saunders Co., 1999.
Dehydration: How to Recognize and Prevent Its Effects. www.medicinenet.com
Ask the Experts! Questions Regarding: Causes and Treatments of Constipation. www.medicinenet.com.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 01/29/2010
Copyright © 01/29/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6085
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