Patient Instructions following Cardiac Surgery (Child)

Important information  

It is important to understand how to care for your child while they recover from cardiac surgery at home. Review these instructions and ask your healthcare team about any questions or concerns you may have.

Surgical incision care instructions

• If your child is discharged home with specific incision care instructions, you will be given a written copy of the instructions and they will be reviewed with you before discharge. 

• The surgical incision takes 2-4 weeks to heal after surgery. Keep the incision clean, dry, and open to air.

• If steri-strips are on the incision, they may take 7-14 days for steri-strips to fall off. As the strips become soiled or if edges begin to curl, you may remove them. If the steri-strips have not fallen off by 14 days, they should be gently removed. 

• It is normal for the incision to feel numb, tingly, or itchy during the healing process. 

• Do not scratch the incision. This could lead to an infection. Cover the incision with a dressing to avoid scratching and if it is irritated by clothing. Change the dressing every day with bathing.

• Do not use antibiotic creams, body creams or lotions on the incision during the 2–4 weeks after surgery. Creams and lotions may be applied after all the scabs have fallen off and the incision is healed. 

• Avoid direct sun exposure to the incision for 6-12 months after surgery. Use sunscreen and have your child wear a shirt whenever you are outside.

• Do not swim or cover the incision with water until it is completely healed.

Bathing instructions

• Gently wash the incision every day with soap and water. Pat dry. Do not scrub the incision.  

• If there are steri-strips, gently wash them with soap and water and pat dry. 

• We recommend that your child take showers instead of baths. Tub baths are allowed if the incision does not get soaked or submerged in water.  

• Infants can be sponge bathed. 

Signs of incision infection

If your child has any signs or symptoms of infection at the incision site, call the Cardiac Surgery office right away:

• Temperature of 100.4°F (38°C) or higher

• Redness

• Warmth

• Swelling

• Drainage

• Opening or separation of the incision edges

Activity guidelines

After cardiac surgery, the breastbone, also called the sternum, will take 6 to 8 weeks to heal. Practice the sternal precautions the healthcare team reviewed with you until you are cleared by the cardiologist to stop them. Avoid activities that could cause strain or trauma to the chest area.

• Avoid gym, contact sports, playground equipment, bike riding, and rough play. 

• Avoid lifting anything that weighs more than 10 pounds. Do not lift backpacks or heavy books for 6 to 8 weeks after surgery. Use a book bag that can be pulled on wheels. Some schools may supply a set of books for home and a set in each classroom.

• Your child should be able to handle more activity and have less pain or discomfort over the first couple of weeks after surgery. 

• Infants should not do tummy time until sternal precautions have been lifted. When picking up your infant, use the scooping technique demonstrated by the healthcare team. Avoid lifting the child from underneath the armpits. You should place one of your arms behind the shoulder blades and the other arm underneath the child's knees, then scoop them into your arms.  

Diet

• Your child’s appetite will slowly return as they recover. Try offering smaller, more frequent meals instead of large ones.

• Your child should eat a well-balanced diet that includes fruits, vegetables, and iron rich foods like green leafy vegetables and red meat.

• If your child was taking a multi-vitamin before surgery, they may start taking one again. 

• If your child is taking Coumadin® after surgery, ask the cardiologist if a multi-vitamin is recommended.

Medicines

• Your child should take all prescribed medicine according to the directions. 

• It is important that you know the name of each medicine, why your child is taking it, how much to take, when and how to take it, and any side effects.

• Call the cardiologist if your child has side effects from prescribed medicine. 

• You may give your child acetaminophen (Tylenol®) or ibuprofen (Motrin®) for discomfort. Follow the directions on the bottle, or as prescribed by your cardiologist.  

• Talk with your child’s cardiologist before giving any herbal medicine, vitamins, or other supplements. 

• If possible, try to fill prescriptions at the CHOP retail pharmacy before discharge. Many of the medicines prescribed are supplied in a liquid preparation by CHOP but may be difficult to find at other pharmacies. If your child needs liquid medicines, call your home pharmacy before discharge to make sure they have the liquid medicine. It can take 2 to 3 days for a pharmacy to get the correct preparation of the medicine. 

• Your child may require antibiotics before dental work, including regular cleanings. This is to prevent an infection of the heart that your child may be at risk for following cardiac surgery. Antibiotics can be ordered by your primary care physician or your cardiologist.

Follow-up care

• Your child will need follow up appointments with the following teams:

• The CT surgery team will follow-up with your child until the child incision is fully healed. The follow-up plan is typically scheduled at time of discharge, and may include in-person or telemedicine visits, or MyCHOP updates. If you do not have a follow-up plan at discharge, please call the Cardiac Surgery office to schedule an appointment. 

• The cardiologist will see most patients within 5 to 10 days after discharge.

• Your child’s primary pediatrician should see your child within 2 weeks of discharge. 

• If your child is discharged home with chest tube sutures (black) they can be removed at your child’s first follow up appointment with the cardiologist, or by your primary care provider. If your primary care provider is not comfortable removing the sutures, or they have not been removed for more than 2 weeks since surgery, schedule an appointment with the CT surgery team. 

• If your child is discharged home with midsternal incision sutures (blue), you can schedule an appointment with the CT surgery team to have them removed. They should be removed within 2 weeks from surgery.

• Call Cardiac Surgery with any questions and concerns. Call immediately for:

• Signs of wound infection

• Nausea or vomiting

• Shortness of breath or difficult breathing

• Extreme fatigue

Cardiac Center Contact Information

Daytime Hours:

• Cardiac Surgery Office, Monday- Friday 8am-5pm: (215) 590-2708

• Cardiology Outpatient Office, Monday- Friday 8:30am-5pm: (215) 590-4040

After 5pm and weekends:

• Call 215-590-1000, ask the hospital operator for the Cardiology Fellow on-call.  

Voorhees Cardiology Office, available 24 hours for Voorhees patients: (856) 783-0287

For non-urgent questions, you may contact our team via MyChop message:

• Send to “CT SURGERY Physician Assistants”

Reviewed 9/6/2024 by Elizabeth Trovato, PA-C