What are the precautions to be taken after anorectal surgery

  I. General 1. Activity Bed rest should be taken on the day of surgery. The next day after surgery, appropriate activities should be gradually performed.  Patients undergoing local anesthesia are generally not required to fast. On the day of surgery, a liquid or semi-liquid diet should be the mainstay. Patients undergoing epidural or subarachnoid anesthesia are required to fast for 6-8 hours and then be given a liquid or semi-liquid diet.  If the stool is hard, the physician should be informed promptly, and oral laxatives, topical corkage, or enema should be given to laxative.  4.Medication Apply antibiotics and hemostatic drugs within 5-7 days after surgery by intravenous drip, some patients need to extend the medication time.  5.Cleaning of the trauma In order to keep the anus clean, the contamination of the trauma by feces and secretions should be removed at any time, and the sitz bath should be started after defecation on the next day after the operation. Our department adopts the sitz bath with nitroxanthin lotion. After surgery, dilute one third of the bottle of nitroxanthin lotion with 1500-2000ml of warm water and sitz bath for 10-20 minutes.  6.Medication change Generally, the gauze can be removed 6-8 hours after surgery, and the medication should be changed after the sitz bath, and the medication should be changed once a day for patients with irregular bowel movements or diarrhea.  Second, the treatment of postoperative complications 1, pain, swelling Postoperative patients generally have mild swelling pain as a normal condition, no special treatment is needed. If the pain is severe, oral painkillers can be taken (note: not to be taken on an empty stomach). Bleeding Bleeding is an important postoperative complication, which can be divided into primary and secondary according to the bleeding time, and into major and minor bleeding according to the bleeding amount. After surgery, we should keep the stool open and avoid strenuous exercise to minimize the occurrence of bleeding.  (1) Primary bleeding is the bleeding seen on the day of surgery, which is caused by incomplete intraoperative hemostasis or inadequate filling. Most anorectal surgeries use open incisions, and a small amount of exuded blood on the gauze after surgery is normal. When there is a lot of bleeding, the medical staff should be notified promptly.  (2) Secondary bleeding A large amount of bleeding occurs 1-2 weeks after surgery and during ligature dislodgement, contact the doctor at any time and go to the hospital.  (3) Anal edge edema Postoperative bleeding anal edema is painful, usually relieved after a week by applying external decongestant cream, and if necessary, be removed.  (4) Urinary retention Mainly manifested as postoperative distension of the abdomen and inability to discharge urine or poor discharge. In 2 hours after surgery, water intake should be controlled appropriately, and urination can be done by oneself in 2-4 hours, so it is not necessary to wait until the urge to urinate is obvious. The abdominal pressure can be increased appropriately during urination without worrying too much about the wound. If urinary retention occurs, you should: 1. massage up and down the bladder area and apply heat for 15-30 minutes. 2. let the patient listen to the sound of running water to urinate. 3. relax the anal filling. 4. catheterize if necessary.  5.Eczema When there are more secretions during the wound healing process, it is easy to impregnate the perianal skin leading to the occurrence of eczema. Therefore, it is necessary to keep the wound surface clean and dry to prevent the occurrence of eczema, such as night sleep, remove the gauze to facilitate local dryness and ventilation. If itching is intense can be used topical drugs such as skin easy.  6. Incisional granulation and delayed wound healing.