Video 4 - When You Have Pectus Excavatum - What to expect after the surgery?
What should I expect after the surgery? And what is the recovery process?
What should you expect after the surgery? And what is the recovery process? In this video, you
will find the answer to these two questions.
You or your child may have pectus excavatum. Our team at Nicklaus Children's Hospital is here to answer your questions and guide you through the treatment process. In this video series
called “Pectus Excavatum,” we will answer most common questions and provide you with
information on how to prepare for a Nuss procedure.
Every patient is different but on average it takes about 4 to 6 weeks to recover from the surgery
although it will take up to 12 weeks before your child returns to normal physical activities,
including sports. Your surgeon will discuss with you when activities can be increased.
The pectus repair is a painful procedure. Following the operation, your child may remain at the
hospital for one or more days to ensure that the postoperative pain management plan is
effective. After the surgery, your child will be given an incentive spirometer, which encourages
deep breathing, to use every hour while awake.
Postoperative Day #0
An X-ray of your child’s chest will be taken to ensure that the bar is in place and that the lungs
are fully expanded. Immediately after the operation, your child will begin sipping liquids and
then move to a regular diet. For the next 24 hours, an IV with antibiotics and physiological
monitoring may be provided to your child. Your child will sit up or get out of bed once they
feel strong enough to do so. Your child will start non opioid oral medications for pain management, nausea, laxative and a muscle relaxant as needed. Opioid medications will be added as needed.
Moving around is an important part of the recovery process. After surgery, your child will get
out of bed and move to a chair with assistance. A physical therapist will teach your child and
you how to get out of bed safely. The method used is having your child lying flat on the back
and coming into a sitting position using the abdominal muscles. A parent must assist the child
during this process.
Postoperative Day #1
Your child will begin to walk with the assistance of a physical therapist or nurse. Walking helps
increase strength and encourages deep breathing. As soon as you get the clearance from the
clinical team, you can help speed up your child's recovery by encouraging activities such as
deep breathing, sitting in a chair, and walking.
Gauze and clear plastic dressings, placed over the incisions, will be removed a few days after
surgery. Your child can bathe with the Steri-strips® in place. They will fall off on their own. In
most operations, the wound is closed with dissolvable sutures(stitches) so they do not have to
be removed.
Once the pain is managed you will be able to go home . Discharge instructions will be given.
Most patients feel better after a week at home; they may shower without restriction and
assistance if needed. The child must stay active at home.
But in order to avoid moving the pectus bar, caution must be taken when advancing
movement. Consequently, your child should not play sports that could cause a chest injury
(such as football, soccer, and baseball) until the surgeon says it''s OK. There may be other
ongoing activity restrictions such as not carrying a backpack at school, no side-lying or lying on
one’s stomach, no heavy lifting or reaching high overhead. Except for these restrictions, your
child can go about daily activities as usual.
Most children can go back to school within a month after their operation. It may take 3 months
or more for your child to return to all previous activities. Make sure your child takes the oral
pain medication with food and as scheduled, eat foods high in fiber and drink plenty of fluids to
prevent constipation.
When does my child see the surgeon again after the operation?
If all is going well, we recommend a visit to our office two weeks after hospital discharge. If
your child has worsening redness, any fluid coming out of the incision, swelling or pain at the
incision site or a fever after , discharge, please call our office immediately.
When are the metal struts/pectus bar removed?
With the minimally invasive repair, the pectus bar may be removed three to four years after
insertion. This is an outpatient operation that takes about one hour. A visit to our office is r
Need to plan for removal of pectus bar. We hope this information is useful to you. Thank you for choosing Nicklaus Children’s, where we strive to create a healthy future for every child.
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