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Craniosynostosis Surgery – Preparing for Surgery

 

Prior to Admission

Your child will be seen at the Craniofacial Center for a pre-op visit prior to surgery.  At that visit, the details of the surgery, preoperative requirements, and recovery will be discussed.  Your child will also need to see their primary physician for a history and physical within 2 weeks of the operative date.

Coming to the Hospital

After surgery, your child will be taken care of in the pediatric intensive care unit (PICU).  The PICU is located on the 3rd floor of the hospital.   After observation in the PICU, your child will be transferred to the pediatric floor.  Typically, the hospital stay is between 2 and 5 days.  The pediatric units provide diapers, formula, and baby food.  You are welcome to bring a few items to make your baby feel more comfortable and secure—such as a favorite toy, stuffed animal, or blanket.  Parents may stay in their child’s room after surgery.  Each unit has specific visiting hours and guidelines.  Please check with the nursing staff on your unit for details.

Day of Admission

The Pre-Surgery department will contact you the day before your child’s surgery.  They will tell you the time of the surgery and at what time you need to arrive. The Admitting/Registration Desk is located in the Main Lobby at Mercy Medical Center.  Remember to bring your insurance card with you.  When checking in, let them know that your child is scheduled for surgery that day.  After you are admitted, you and your child will be taken to the pre-surgery area where the nurses and anesthesiologist who will be taking care of your child will meet with you.  Dr. Maurice and Dr. Gachiani will also visit with you there.

Surgery time varies with each case depending on the amount of repair that is required.  Time in the operating room is on average is between 3 and 7 hours. 

During surgery, you may wait in the Surgical Waiting Room, which is located on the first floor of the hospital across from Starbucks.  After surgery, Dr. Maurice will speak with you.  After surgery, your child will either go to the recovery room or directly up to the PICU.  You will be reunited with your child when they reach the PICU. 

After Surgery

Your child may be awake, sleepy, or asleep when he or she is transferred from the recovery room to the pediatric unit.  Your child will have a white gauze head wrap dressing in place.  Your child will have a few tubes and wires attached to him or her.  These may include a pulse oximeter (a monitor that helps measure the oxygen level in your child’s blood), cardiac monitor (a monitor that record’s your child’s heart rate and rhythm), and “lines” (plastic tubes placed in the veins and arteries to monitor blood pressure and to administer fluids and medicines that can’t be taken by mouth).  Your child may have some discomfort after surgery.  We will give your child pain medicines through the IV line or by mouth.

Care During Recovery

The head wrap dressing is usually removed within 24 and 48 hours after surgery.  There will be a suture line where the repair was performed.  The head and eyes may appear swollen; this swelling usually peaks at 48 to 72 hours after surgery and usually decreases within 3 to 5 days.  Your child may be fussy or irritable for a while after surgery; this may last about 3 to 7 days.

To help prevent falls, be sure to keep the side rails of your child’s crib up.  Your child will be placed in arm immobilizers to help prevent him or her from touching his or her head and disrupting the incision.  Under supervision, the arm restraints should be taken off four times a day to check for skin irritation.  Loosen only one at a time, and do not let your child’s hands near his or her incision.  Exercise your child’s arms when the restraints are off so that they don’t become stiff.  Otherwise, your child should remain in the restraints at all times.  Your baby must wear the restraints for 2 weeks following surgery.  Arm immobilizers can make your child clumsy, so if your child is walking, watch for falls.

After You Go Home

The sutures used to close the scalp are dissolvable.  Apply the antibiotic ointment prescribed to the scalp incision for the first week after surgery.  There will be a scar on your child’s head that will become less noticeable over time.  Sun exposure to the incision should be minimized for 12 months to reduce darkening of the scar.

Pain Management

Immediately after surgery, your child will receive pain medication through the IV.  When your child is tolerating fluids, he or she will be given liquid pain medications by mouth (usually either Tylenol with hydrocodone or regular Tylenol).  You will be sent home with a prescription for pain medications for your child.  Ibuprofen (e.g. Advil, Motrin) can be used only after being OK’d by either Dr. Maurice or Dr. Gachiani.

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Des Moines, Iowa 50314

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