Post-operative care for orthognathic patients

  1.After general anesthesia surgery, the patient needs to be monitored in the ward for one day, according to the postoperative care of general anesthesia.  (1) Keep the respiratory tract unobstructed: closely observe the vital signs, observe the patient’s breathing, tilt the head to the side to facilitate the discharge of oral secretions, and suck out the secretions in the nasal and oral cavities in a timely manner. Loosely cover the patient’s mouth and nose with two layers of wet gauze to allow the patient to inhale moist air.  (2) Local cold compresses: cold compresses with ice bags on the surgical site within 24 hours after surgery can effectively reduce postoperative edema.  (3) Treatment of nausea and vomiting: intermittent gastrointestinal decompression, aspiration of blood and gastric contents accumulated in the stomach, appropriate antiemetic medication, such as intermaxillary traction, bedside preparation of wire cutters, ligature wire should be cut when vomiting to prevent asphyxiation.  2.Return to the ward and hand over to the nurse of the monitoring ward to understand the patient’s condition.  3.Elevate the head of the bed by 30°~40° and make the patient semi-recumbent to reduce facial swelling and bleeding and facilitate the discharge of intra-oral secretions, and prepare suction devices at the bedside.  4. Apply antibiotic ointment to the lips and corners of the mouth to keep the lips clean and moist to avoid infection and promote healing.  5.Timely aspirate the secretions in the mouth, with gentle aspiration movements to avoid the wound. Give nebulized inhalation for 5 days, 2 times/day, which can dilute the sputum and reduce the pain in the pharynx.  6.Care of retained gastric tube.  7.Nutritional guidance (1)Nasal feeding of fluid food should be small and multiple meals, about 200ml each time, with appropriate temperature, comprehensive nutrition, and sweet into the mix.  (2) Give the patient a high-calorie, high-protein diet, which should provide 1 509 protein and 1 O.45 kJ of calories per day.  (3) The weight loss in the early postoperative period should not exceed 5% to 7% of the preoperative weight. If the patient continues to lose weight 1 O days after surgery, it may indicate nutritional deficiency and protein and calorie intake should be increased.  (4) Care of postoperative diet: liquid diet.  8.Keep the mouth clean Nasal feeders should also drink more water in the mouth to play the role of flushing the mouth. Oral rinsing 2 times/day for 5-7 days after 48 hours of surgery to prevent wound infection.  9.Give antibiotics, glucocorticoids and hemostatic drugs as prescribed by the doctor, and pay attention to the reaction after medication.  10.Encourage patients to get out of bed or move around in bed to facilitate recovery. When the patient gets out of bed, someone must follow and take care of the patient to avoid fainting. As the patient is weak after surgery, only a little liquid food is easily hungry and easily dizzy.