Home Care after Thoracotomy
What is a thoracotomy?
A thoracotomy is a surgical incision of the chest wall (about 4-6 inches long) that is made between muscles of the chest wall, then between two ribs. Sometimes a part of the rib is taken out. You will require one or more chest tubes after a thoracotomy.
After the chest tube is removed, leave the chest tube dressing in place for 48 hours.
Remove the dressing on ______________________.
After the chest tube dressing is removed, you may shower or wash the incisions daily with mild soap and water. Do not put lotions, powders, or antibacterial ointments on the incisions. Pat your incisions dry. Do not rub them because it prevents healing.
Do not soak in a bathtub or hot tub or go swimming until your incisions have healed.
Check your incisions daily for signs and symptoms of infection. These include:
- Increased redness
- Pus-like drainage
- Excess swelling
- Temperature (by mouth) greater than 100.4° F for two readings, 4 hours
There should be no drainage from your incision. Any drainage from the chest tube site will be only a scant amount for a day or two. Wear a Band-Aid or small dressing over the site until the drainage stops. Change the dressing daily and as needed.
When you go home, your incision may have staples or stitches in place. Sometimes, small pieces of tape called steri-strips are placed after your staples are removed. It is okay if these tape strips fall off, but don’t pull them off. When you return for your clinic visit in 1-2 weeks, the doctors will remove staples or stitches that are left.
It is very common to have pain after a thoracotomy.
When you are in pain, take your pain pills as ordered. If the pain is sharp and constant or gets worse, call your doctor.
Other pain management techniques:
- Warm showers (once chest tube dressing is removed) to help loosen the muscles.
- Heating pads: near the incision site, make sure to place a towel between you and the heating pad to prevent burns.
- Splinting with coughing (hold a pillow tight against the chest when coughing).
- Walk 3-4 times each day.
- Use your incentive spirometer 10 times every couple of hours.
- Do range of motion exercises with your arms10 times each 2-3 times daily for 3 weeks on the side where the thoracotomy incision was made. It may feel best to do these in the shower; the warm water will loosen the muscles making the exercises easier to do.
o Raise your arm over your head with the elbow straight. Bring the
arm towards your ear.
o Place your hand behind your neck and try to move that hand towards
the opposite shoulder blade.
o Hold your arm straight out in front of you and cross it over to the other
side of your body.
o Shrug your shoulders up, down and in circles.
o Squeeze your shoulder blades together
- Use the arm on your surgery side as you normally would in your daily routine (dressing, showering, and combing hair).
- Do not drive for 4 weeks or if you are using narcotic pain pills.
- Do not lift greater than 10 pounds (gallon of milk) for about 4 weeks or until instructed by the doctor.
When to Call the Doctor
- Signs of infection (listed above)
o Increased redness
o Pus-like drainage
o Excess swelling
o Temperature (by mouth) greater than 100.4° F for two readings, 4
- Sudden onset of sharp chest pain with shortness of breath
Surgery Clinic: Monday – Friday, 8:00 a.m. – 4:30 p.m. (608) 263-7502
Dr. Maloney’s office: (608) 263-5215
Dr. Macke’s Office: (608) 263-5215
Dr. Blasberg’s Office: (608) 263-5215
After hours, the clinic number will be answered by the hospital paging operator at (608) 262-2122. Ask for the thoracic surgery resident on call. Leave your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call: Toll Free 1-800-323-8942
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: 09/16/2013
Copyright © 09/16/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5836
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