After Pectus Excavatum Surgery
The Pediatric Surgery team at American Family Children's Hospital in Madison, Wisconsin, treat children with pectus excavatum, also known as sunken chest or funnel chest.
Care of Incisions After Surgery
Outer bandages may be removed two days following surgery. Underneath these dressings are white steri-strips over the incisions. Do not pull these off. The strips will curl up and fall off on their own as the incisions heal. If steri-strips are still on after one week, you may gently remove them.
All surgical incisions are closed using dissolving stitches that are beneath the skin. The incisions will be pink at first, then will gradually fade over the next year. You should notify your child's doctor if there is any redness, increased swelling or drainage from the incisions. Your child will need prescription pain control for up to three weeks. After this time, pain should be controllable with ibuprofen (Motrin/Advil) or acetaminophen (Tylenol).
Going Back to School
- Usually children need to be home for one to two weeks after surgery. Your child may return to school when energy level and pain control permits.
- Your child may not participate in gym class or recess for the first two months or carry heavy books due to discomfort. You may want to consider making arrangements for books to be placed in the classroom. Another option is the use of a rolling backpack.
- Walking up or down stairs is allowed anytime.
Activity after Surgery
- Activity will be very limited during the two months following the operation, so the bar is not dislodged. Your child cannot participate in sports or physical education during this time.
- Your child will not be allowed to lift anything that weighs more than 25 pounds during this time.
- Contact sports will not be allowed for at least two to three months. After that, any activity restrictions will be directed by your surgeon.
- After your child has recovered, exercises for the chest strengthening should be restarted.
- Good posture is extremely important.
Pain and Constipation
One of the main side-effects of prescription pain medication is constipation. While constipation is a topic most children and adolescents do not like to discuss, it is important for them to be aware of this common and troublesome side effect. Patients may report nausea and difficulty eating and drinking four or five days after surgery. If children are not able to eat, they will not be able to tolerate the pain medication. This usually occurs in patients who have not been able to have a bowel movement since prior to surgery.
The most effective way to facilitate a bowel movement at this stage is an enema. If your child is in the hospital, the nursing staff will help administer the enema. If your child has been discharged, a Fleets enema may be purchased over-the-counter.
We will see your child two to four weeks after the operation. Additionally, your child will be seen every year until the bar is removed.
Call your child's surgeon if:
- Your child's incision is red, swollen, very painful, or has drainage.
- You think the bar has become dislodged (chest changes shape, your child has been hit forcefully in the chest).
- Your child is still having difficulty having bowel movements after an enema.
- You have questions or concerns.
Additional Post-surgery Information
- You may want your child to wear a medical bracelet or necklace. The inscription should state: "Steel bar in chest, CPR more force, cardiac defibrillation ant/post pad placement."
- No chest or thorax MRIs are allowed. If an MRI of the lower body is needed, consult with the radiologist first to assure the safety of the MRI with the steel bar in place.
- Antibiotic prophylaxis is not needed for dental procedures unless your child has a history of mitral valve prolapse.
- We will provide a medical travel letter which your child may need in passing through security devices at airports, etc.