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Vulvectomy surgery—Discharge information

Wound Care

The stitches are dissolvable and covered with a glue film which will peel off by itself. Keep the wound clean and dry.

Do:

  • continue washing your wound 3 times a day and after passing urine or bowel motion until the area is healed (you have been taught how to clean the area by a nurse while you were in hospital)
  • use water only to wash the area and use either a spray bottle with a nozzle or handheld shower nozzle. Pat area dry.
  • apply chlorsig ointment or betadine (if your doctor has prescribed either of these for you) until the container is finished. You will not need to apply ointment/betadine after this time. (1, 2)

Do not:

  • have a bath as this increases risk of infection—shower only
  • wear tight clothing—aim for cotton underwear and loose fitting clothing
  • use lotions, perfumes, or talcum power on vulva area
  • use tampons until area is completely healed—use sanitary pads for any blood loss. (1, 2)

Pain Management

Paracetamol (up to 8 tablets a day) and anti-inflammatory tablets (as prescribed) are the most common pain relief given after surgery. Stronger pain tablets (such as Panadeine or Endone) cause constipation but use as needed. (2)

Diet

Avoid constipation by:

  • drinking extra fluids, especially water
  • drinking pear or prune juice and add extra fibre to your diet
  • using laxatives (as directed by your doctor or pharmacist) to ensure bowel motions are soft and easy to pass with no straining. (3)

Activity

  • The amount of physical activity you can undertake following this surgery depends upon the size and the site of surgery performed. On discharge you will be given information regarding:
    • rest required and positioning
    • amount of time you can sit upright
    • the use of a pressure cushion (if required). (5)
  • Continue wearing your TED stockings to avoid blood clots until you are back to full mobility (refer to blood clot brochure)
  • Avoid driving until the wound area has healed. Check your insurance policy to ensure there are no exclusion clauses following surgery
  • Returning to work depends upon the type of work you do and how much sitting and walking is involved. Discuss this with your doctor

Removal of lymph nodes

  • If your surgery included removal of lymph nodes, there is a risk of developing lymphedema (6). Please discuss with this the physiotherapist or nurse prior to going home. A lymphedema brochure is available on request
  • If you have a full groin node dissection and you go home with the drain insitu, you will be asked to empty the drain and record daily output from the drain. Once the output is below 20ml per day, the drain can be removed
  • Removal of the drain will be organised by the Gynae-oncology Clinical Nurse

Symptoms to seek advice for:

  • onset of shivers, fevers or chills
  • burning, stinging or frequency of urine
  • onset of sudden pains or shortness of breath
  • hot or painful area in your calf muscle
  • increased pain, bleeding, discharge or odour from the either the wound or the vagina. (2)

Follow-up appointments

  • The doctor will phone you with the pathology results following surgery. You will receive the phone call 7–10 days after your surgery (usually late on Monday afternoon or Tuesday)
  • A follow-up appointment will be scheduled 6-8 weeks post-surgery and sent out in the mail. Alternatively this follow-up appointment may be with your referring doctor or GP if you live out of town
  • If you need further treatments or an earlier appointment this will be arranged and you will be contacted

After discharge from hospital, please contact Ward 8B via switch on 07 3163 8111 if you have any concerns.

References

  1. Fernandez R, Griffiths R. Water for Wound Cleansing. Cochrane Database of Systematic Review. 2012.
  2. Handbook AM. Australian Medicines Handbook. Adelaide: Australian Medicines Handbook Pty. Ltd.; 2015.
  3. Sandeep M. Evidence Summary: Post-operative care Nursing management. 2013.
  4. Slade S. Constipation Management. 2014.
  5. Helm C, Goff B, Falk S. Vulvectomy and Post-operative care. UpToDate. 2013.
  6. Finnane A, Hayes SC, Obermair A, Janda M. Quality of life of women with lower-limb lymphedema following gynecological cancer. Expert review of pharmacoeconomics & outcomes research. 2011;11(3):287-97.
Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420096
Last modified 13/7/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 22/6/2016
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