Editing Surgery (section)

===Postoperative care===
After completion of surgery, the person is transferred to the [[post anesthesia care unit]] and closely monitored.  When the person is judged to have recovered from the anesthesia, he/she is either transferred to a surgical ward elsewhere in the hospital or discharged home.  During the post-operative period, the person's general function is assessed, the outcome of the procedure is assessed, and the surgical site is checked for signs of infection. There are several risk factors associated with postoperative complications, such as immune deficiency and obesity. Obesity has long been considered a risk factor for adverse post-surgical outcomes. It has been linked to many disorders such as obesity [[hypoventilation]] syndrome, [[atelectasis]] and pulmonary embolism, adverse cardiovascular effects, and wound healing complications.<ref>{{cite journal | vauthors = Doyle SL, Lysaght J, Reynolds JV | title = Obesity and post-operative complications in patients undergoing non-bariatric surgery | journal = Obesity Reviews | volume = 11 | issue = 12 | pages = 875–886 | date = December 2010 | pmid = 20025695 | doi = 10.1111/j.1467-789X.2009.00700.x | s2cid = 7712323 }}</ref> If removable skin closures are used, they are removed after 7 to 10 days post-operatively, or after healing of the incision is well under way.{{citation needed|date=May 2023}}

It is not uncommon for [[Drain (surgery)|surgical drains]] to be required to remove blood or fluid from the surgical wound during recovery. Mostly these drains stay in until the volume tapers off, then they are removed. These drains can become clogged, leading to [[abscess]].<ref>{{Cite web|vauthors=Pastorino A, Tavarez MM|title=Incision and drainage|date=24 July 2023|publisher=StatPearls Publishing|pmid=32310532 |url=https://www.ncbi.nlm.nih.gov/books/NBK556072/|accessdate=11 March 2024}}</ref>

Postoperative therapy may include [[adjuvant]] treatment such as [[chemotherapy]], [[radiation therapy]], or administration of [[medication]] such as [[anti-rejection medication]] for transplants. For postoperative nausea and vomiting (PONV), solutions like saline, water, controlled breathing placebo and aromatherapy can be used in addition to medication.<ref>{{cite journal | vauthors = Hines S, Steels E, Chang A, Gibbons K | title = Aromatherapy for treatment of postoperative nausea and vomiting | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | issue = 3 | pages = CD007598 | date = March 2018 | pmid = 29523018 | pmc = 6494172 | doi = 10.1002/14651858.CD007598.pub3 }}</ref> Other follow-up studies or [[Physical therapy|rehabilitation]] may be prescribed during and after the recovery period. A recent post-operative care philosophy has been early ambulation. Ambulation is getting the patient moving around. This can be as simple as sitting up or even walking around. The goal is to get the patient moving as early as possible. It has been found to shorten the patient's length of stay. Length of stay is the amount of time a patient spends in the hospital after surgery before they are discharged. In a recent study<ref>{{cite journal | vauthors = Huang J, Shi Z, Duan FF, Fan MX, Yan S, Wei Y, Han B, Lu XM, Tian W | title = Benefits of Early Ambulation in Elderly Patients Undergoing Lumbar Decompression and Fusion Surgery: A Prospective Cohort Study | journal = Orthopaedic Surgery | volume = 13 | issue = 4 | pages = 1319–1326 | date = June 2021 | pmid = 33960687 | pmc = 8274205 | doi = 10.1111/os.12953 }}</ref> done with lumbar decompressions, the patient's length of stay was decreased by 1–3 days.

The use of [[Antibacterial|topical antibiotics]] on surgical wounds to reduce infection rates has been questioned.<ref name="AADfive">{{Citation |author1 = American Academy of Dermatology |author1-link = American Academy of Dermatology |date = February 2013 |title = Five Things Physicians and Patients Should Question |publisher = [[American Academy of Dermatology]] |work = [[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |url = http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-dermatology/ |access-date = 5 December 2013 |url-status=live |archive-url = https://web.archive.org/web/20131201171621/http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-dermatology/ |archive-date = 1 December 2013 }}, which cites
* {{cite journal | vauthors = Sheth VM, Weitzul S | title = Postoperative topical antimicrobial use | journal = Dermatitis | volume = 19 | issue = 4 | pages = 181–189 | year = 2008 | pmid = 18674453 | doi = 10.2310/6620.2008.07094 }}</ref> Antibiotic ointments are likely to irritate the skin, slow healing, and could increase risk of developing [[contact dermatitis]] and [[antibiotic resistance]].<ref name="AADfive"/> It has also been suggested that topical antibiotics should only be used when a person shows signs of infection and not as a preventative.<ref name="AADfive"/> A systematic review published by [[Cochrane (organisation)]] in 2016, though, concluded that topical antibiotics applied over certain types of surgical wounds reduce the risk of surgical site infections, when compared to no treatment or use of [[antiseptic]]s.<ref>{{cite journal | vauthors = Heal CF, Banks JL, Lepper PD, Kontopantelis E, van Driel ML | title = Topical antibiotics for preventing surgical site infection in wounds healing by primary intention | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | issue = 11 | pages = CD011426 | date = November 2016 | pmid = 27819748 | pmc = 6465080 | doi = 10.1002/14651858.cd011426.pub2 | url = http://espace.library.uq.edu.au/view/UQ:413965/UQ413965_OA.pdf | archive-url = https://web.archive.org/web/20180723044104/https://espace.library.uq.edu.au/data/UQ_413965/UQ413965_OA.pdf?Expires=1532371516&Signature=Ga9lfd5ycgb~3Rlr6lSj4JcYzJOD6h9bENz7GeJxXLNvKB3KEDh3tRf90xQlPyB2yfMVoqOUelfouffZI0jt0TVWtXN9N9RC6CoJfI7LevaXtxnuWQmz~wcsDRjBZynlpjUa3uo44kv6ak6IVlKLFQ6QMXRs2J-6cf1J8jEx31QUOrISujNEWq1aSkR7IwkURK7x5MprcFoGfwaiqD74YZ64hLTWaQai-Zhd435OetLwPYT-tu3aOY5~Fe2egUuK2ubtVVQhaAS-mt5bMGaj59z3gcdQo6vTfEATZ~a3wlQzUXyEZPPQC6DCuYYiUU7nO6WocS2AwswNxH7edl1gJQ__&Key-Pair-Id=APKAJKNBJ4MJBJNC6NLQ | archive-date = 23 July 2018 }} [http://man.ac.uk/a7GkYb Alt URL]</ref> The review also did not find conclusive evidence to suggest that topical antibiotics increased the risk of local skin reactions or antibiotic resistance.{{citation needed|date=May 2023}}

Through a retrospective analysis of national administrative data, the association between mortality and day of elective surgical procedure suggests a higher risk in procedures carried out later in the working week and on weekends. The odds of death were 44% and 82% higher respectively when comparing procedures on a Friday to a weekend procedure. This "weekday effect" has been postulated to be from several factors including poorer availability of services on a weekend, and also, decrease number and level of experience over a weekend.<ref>{{cite journal | vauthors = Aylin P, Alexandrescu R, Jen MH, Mayer EK, Bottle A | title = Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics | journal = BMJ | volume = 346 | pages = f2424 | date = May 2013 | pmid = 23716356 | pmc = 3665889 | doi = 10.1136/bmj.f2424 }}</ref>

Postoperative pain affects an estimated 80% of people who underwent surgery.<ref name=":0">{{cite journal | vauthors = Doleman B, Leonardi-Bee J, Heinink TP, Bhattacharjee D, Lund JN, Williams JP | title = Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | issue = 12 | pages = CD012624 | date = December 2018 | pmid = 30521692 | pmc = 6517298 | doi = 10.1002/14651858.CD012624.pub2 }}</ref> While pain is expected after surgery, there is growing evidence that pain may be inadequately treated in many people in the acute period immediately after surgery. It has been reported that incidence of inadequately controlled pain after surgery ranged from 25.1% to 78.4% across all surgical disciplines.<ref>{{cite journal | vauthors = Yang MM, Hartley RL, Leung AA, Ronksley PE, Jetté N, Casha S, Riva-Cambrin J | title = Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis | journal = BMJ Open | volume = 9 | issue = 4 | pages = e025091 | date = April 2019 | pmid = 30940757 | pmc = 6500309 | doi = 10.1136/bmjopen-2018-025091 }}</ref> There is insufficient evidence to determine if giving opioid pain medication pre-emptively (before surgery) reduces postoperative pain the amount of medication needed after surgery.<ref name=":0" />

Postoperative recovery has been defined as an energy‐requiring process to decrease physical symptoms, reach a level of emotional well‐being, regain functions, and re‐establish activities.<ref>{{cite journal | vauthors = Allvin R, Berg K, Idvall E, Nilsson U | title = Postoperative recovery: a concept analysis | journal = Journal of Advanced Nursing | volume = 57 | issue = 5 | pages = 552–558 | date = March 2007 | pmid = 17284272 | doi = 10.1111/j.1365-2648.2006.04156.x }}</ref> Most people are discharged from the hospital or surgical center before they are fully recovered.  The recovery process may include complications such as [[postoperative cognitive dysfunction]] and [[postoperative depression]].<ref>{{Cite journal |last1=Lin |first1=Xianyi |last2=Chen |first2=Yeru |last3=Zhang |first3=Piao |last4=Chen |first4=Gang |last5=Zhou |first5=Youfa |last6=Yu |first6=Xin |date=February 2020 |title=The potential mechanism of postoperative cognitive dysfunction in older people |url=https://pubmed.ncbi.nlm.nih.gov/31765741 |journal=Experimental Gerontology |volume=130 |pages=110791 |doi=10.1016/j.exger.2019.110791 |issn=1873-6815 |pmid=31765741|doi-access=free }}</ref><ref>{{Cite journal |last1=Ghoneim |first1=Mohamed M. |last2=O'Hara |first2=Michael W. |date=2016-02-02 |title=Depression and postoperative complications: an overview |journal=BMC Surgery |volume=16 |pages=5 |doi=10.1186/s12893-016-0120-y |doi-access=free |issn=1471-2482 |pmc=4736276 |pmid=26830195}}</ref>