Home Care after an Endarterectomy
An endarterectomy is a surgery to remove a blockage, such as plaque or a blood clot, in a blood vessel. This restores normal blood flow to the part of the body supplied by the blood vessel. You can have an endarterectomy on the blood vessels in your arms or legs. You can also have one on the blood vessels leading to your kidneys, spleen, intestines, and liver.
Incision Care
Your incision is most often closed with staples or stitches. You may get the incision wet in the shower. Do not swim or take tub baths. Clean it gently with mild soap and water. Remove any dried drainage. Do not scrub the incision. Rinse it and pat the incision dry. Do not use any lotions, alcohol, powders, or oils on your incision, unless told by your doctor. The doctor and nurses will tell you how to take care of your incisions at home. Most of them can be left open to air except for those in the groin. Groin incisions need a dressing. Make sure you let the incision dry completely before you apply a new dressing.
At your first follow up clinic visit, your staples or stitches may be removed. Small pieces of tape called Steri-Strips® may be placed on the incision to help support it. You may shower with the Steri-Strips® in place. Allow the water to flow gently over the area. Do not rub the incision. Gently pat the incision dry. After 2-3 days the Steri-Strips® will begin to curl up at the ends. With time, the strips will fall off on their own. Do not swim or take tub baths.
Pain
It is normal to have some pain at the incision site after surgery. Your doctor may have prescribed pain medicine for you to use at home. This is often the same medicine you have been taking in the hospital. The pain will decrease as the incision heals. You should then need less pain medicine. At that time you can use an over-the-counter pain medicine such as acetaminophen (Tylenol) or ibuprofen (Advil). Talk to your doctor before starting these. Do not drive when taking narcotic pain medicine, such as oxycodone.
The narcotic pain medicine can make you constipated. To prevent this, you can use over-the-counter stool softeners (Senna/Docusate) as needed. Other ways to prevent constipation include drinking fluids and eating fiber. Vegetables and fruits (prunes, raisins, apples, oranges, potatoes, spinach, and carrots) and whole grain breads and rice have fiber. Staying active also helps prevent constipation.
Activity
When you go home you should be able to do most of your basic daily routines. You will need to give yourself time for rest. You may feel weaker. You may notice that you become tired more easily than before. This is normal.
Your sleeping pattern should return to normal. Your strength and energy level will increase as your body recovers. Walking is good for you. But be sure to start slowly. You should increase your distance a little bit each day. This will help you become stronger. Walking will also help prevent constipation and blood clots.
There are some things that you should not do in the first few weeks after surgery.
- Do not lift more than 5-10 pounds during the first 2 weeks at home. This includes groceries, pets, and children. One gallon of milk is about 8 pounds.
- Do not drive until your doctor says it is okay. This will likely be after the first clinic visit. Do not drive while taking narcotic pain medicine.
- Do not play contact sports or do exercise other than walking until your doctor approves.
- Ask your doctor at your follow-up visit when you may return to work and resume sexual activity.
Diet
It is common after this type of surgery to have less of an appetite. You may even lose weight. Even if your appetite is poor you should try to eat. Eating well helps your body heal. It may be easier to eat small amounts of food more often during the day instead of eating three large meals. You must also drink enough fluid to stay hydrated. If you are dehydrated you can become weak and tired quickly. Drink at least 8 to 10 eight-ounce glasses of fluid each day. Water and milk are good options. Caffeine drinks (soda, coffee) can dehydrate your body so are not the best choice for helping you to stay hydrated.
You should also be eating a heart healthy diet.
• Eat less saturated fat. Eat less fatty meats, fried foods, butter, and whole
milk dairy products.
• Eat less trans fats. Eat less deep fried foods, donuts, cookies, and
desserts.
• Eat less carbohydrates. Eat less sugars and sweetened drinks.
• Eat less sodium. Eat less processed foods. Do not add extra salt to your
food.
• Eat less cholesterol. Eat less egg yolks, shrimp.
When to Call your Doctor
You should look at your incision two times a day. Watch for signs of infection. If you notice any of the signs or symptoms listed below, please call your doctor.
• An increase in redness or warmth at the site of the incision.
• Red streaks on your skin that extend from the site where the stitches or
staples are.
• Bulging or swelling at the incision.
• New drainage or bleeding from your incision. Drainage may be cloudy,
yellow, green, or foul-smelling.
• Open spots between the stitches or staples where the skin is pulling apart.
• If you notice the skin along the incision is getting darker or turning black.
• Sudden increase in pain that is not relieved by your pain medicine.
• A temperature of more than 101.5° F (38.5°C) by mouth for two readings
taken 4 hours apart.
What You Can Do to Stay Healthy
Although an endarterectomy may reduce your risk of stroke, heart attack or other problems caused by poor blood flow, it does not stop plaque from building up. To prevent hardening of the arteries from forming again, you should try to change your lifestyle. This includes:
Quit smoking.
Reduce stress in your life.
Control high blood pressure and diabetes.
Exercise regularly, especially aerobic exercises such as walking.
Maintain an ideal body weight.
Keep taking your medicines if you have high cholesterol, high blood pressure, or diabetes, unless your doctor changes them.
Follow up
Most patients return to the Vascular Surgery Clinic about two weeks after they go home. Your staples or stitches may be removed at this visit.
Phone Numbers
Vascular Surgery Clinic at (608) 263-8915 from 8:00 am to 5:00 pm Monday through Friday.
After hours, holidays and weekends, your call will be answered by the paging operator. Ask for the Vascular Surgery doctor on-call. Give 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.
References
Fahey, Victora A. 4th Ed. Vascular Nursing. Philadelphia: WB Saunders Co., 2004.
Society for Vascular Surgery. (2012). Endarterectomy. Vascular Web.
Retrieved October 23, 2012, from http://www.vascularweb.org.
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: 12/26/2012
Copyright © 12/26/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7460
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