Patient Instructions Following Thoracotomy: Infant/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
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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.
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The thoracotomy incision takes 2-4 weeks to heal after surgery. Keep the incision, clean, dry and open to air.
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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.
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It is normal for the incision to feel numb, tingly, or itchy during the healing process.
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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.
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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.
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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.
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Do not swim or cover the incision with water until it is completely healed.
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Once the skin has healed and there are no open areas or signs of infection at the incision site, you should begin scar massage. We will teach you how to do this.
Bathing instructions
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Wash the incision every day. Gently wash with soap and water and pat dry. Do not scrub the incision.
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If there are steri-strips, gently wash them with soap and water and pat dry.
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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.
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Infants can be sponge bathed.
Signs of an incision infection
If your child has any signs or symptoms of an infection at the incision site, call the Cardiac Surgery office right away:
Activity guidelines
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If you have questions about positioning or movement after discharge, please contact your primary care provider for a referral to outpatient therapy.
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For all ages, play and movement are recommended. Activities may need to be modified for pain.
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If your child has shortness of breath, difficulty breathing, or gets very tired after activities, call the cardiologist immediately.
Infant-toddler
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Your infant may have tummy time.
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It is important to hold your infant up over your shoulder (chest to chest) to keep their neck and back muscles strong.
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It is safe to lift your child up under their arms after a thoracotomy procedure, but it may be uncomfortable for the child. It is best to scoop your baby when picking them up while the incision is healing (one hand under the head and one hand under the bottom).
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It is important for your child to gradually move their arm as much as possible. Some examples include: reaching up high or overhead for a toy, rolling from side to side, crawling, and using arms to change from one position to another.
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For 4 weeks after the thoracotomy, your child should avoid hanging activities like monkey bars, hanging by an adult’s hands, and being pulled up from the ground by the hand or arm.
School age-adolescent
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It is important for your child to gradually move their arm as much as possible. Some examples include: reaching up high to get things (out of cabinets, closets, etc.), combing the back of their hair, etc.
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For 4 weeks after the thoracotomy, your child should avoid hanging activities like monkey bars, doing chin-ups or pull-ups and lifting anything heavier than 10 pounds.
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Your child should be able to handle more activity and have less pain or discomfort over the 2 weeks after surgery. If your child does not progress, contact the cardiologist.
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Children may return to school 1–2 weeks after surgery, after their follow-up appointment with the cardiologist.
Diet
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Your child should eat a well-balanced diet that includes fruits, vegetables, and iron rich foods like green leafy vegetables and red meat.
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If your child was taking a multi-vitamin before surgery, they may start taking one again.
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If your child is taking Coumadin™ after surgery, ask the cardiologist if a multi-vitamin is recommended.
Medicines
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Your child should take all prescribed medicine according to the directions.
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It is important that you know the name of each medicine, why you are taking it, how much to take, when and how to take it, and any side effects.
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Call the cardiologist if your child has side effects from prescribed medicine.
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You may give your child acetaminophen (Tylenol®) or ibuprofen (Motrin®) for discomfort. Follow the directions on the bottle, or as prescribed by your cardiologist.
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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.
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Your child may require antibiotics before dental work, including your 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
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Most patients need to be seen by the cardiologist within 5–10 days after discharge.
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Schedule an appointment with your pediatrician within 2 weeks of discharge.
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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.
Call Cardiac Surgery with questions and concerns. Call immediately for:
Daytime Hours:
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Cardiac Surgery Office, Monday- Friday 8am-5pm: (215) 590-2708
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Cardiology Outpatient Office, Monday- Friday 8:30am-5pm: (215) 590-4040
After 5pm and weekends:
Voorhees Cardiology Office, available 24 hours for Voorhees patients: (856) 783-0287
Reviewed 9/6/2024 by Elizabeth Trovato, PA-C