Maju Ilmiah(1)

CHAPTER 10 Postoperative Patient Management

Penyakit kelenjar Salivary

olehGostry Aldica Dohude

pembimbingdr. Sinta SARI RatuNanda.,m.kes, Sp.t.h.t.k.l (K)

BAGIAN ILMU KESEHATAN TELINGA HIDUNG TENGOROKANBEDAH KEPALA LEHERFAKULTAS KEDOKTERANUNIVERSITAS PADJAJARANBANDUNG2015

Pendahuluan. Kelenjar Parotis

Kelenjar parotis merupakan kelenjar ludah terbesarKelenjar parotis mengalirkan saliva yang bersifat serous kedalam rongga mulut melalui duktus stensen

ANATOMI KELENJAR LUDAH

CONTROL OF POSTOPERATIVE HEMORRHAGE

three characteristics of the pain that occurs after tooth extraction :the pain is usually not severe and can be managed in most patients with mild analgesics.the peak pain experience occurs about 12 hours after the extraction and diminishes rapidly after that.Significant pain from extraction rarely persists longer than 2 days after surgery. With these factors in mind, patients can best be advised regarding the effective use of analgesics.

CONTROL OF POSTOPERATIVE Pain and Discomfort

A high-calorie, high-volume liquid or soft diet is best for the first 12 to 24 hours.Patient must have an adequate intake of fluid for the first 24 hours.Food in the first 1 2 hours should be soft and cool.If the patient had multiple extractions in all areas of the mouth, a soft diet is recommended for several days after the surgical procedure.Diabetic patient should be encouraged to return to their normal insulin and caloric intake as soon as possibleDietPatients should be advised that keeping the teeth & mouth clean results in a more rapid healing.Patient may gently brush the teeth that are away from the area of surgery.Avoid immediate brushing the postoperative site to prevent a new bleeding, avoid disturbing sutures, & avoid inducing more pain.The next day, patients should begin gentle rinses with dilute salt (warm) water.If oral hygiene is likely to be difficult after extractions in multiple areas of the mouth, mouth rinses with agents such as dilute hydrogen peroxide may be used. 3 times a day for approximately 1 week.Oral Hygiene

Edema

Once the surgery is completed, use ice packs to help minimize the swelling and make the patient feel more comfortable. On the second postoperative day, neither ice nor heat should be applied to the face. On the third and subsequent postoperative days, application of heat may help to resolve the swelling more quicklySwelling usually reaches its maximum 36 to 48 hours after surgery.Prevention and Recognition of Infection

The principles are to minimize tissue damage, remove sources of infection, and cleanse the wound.Antibiotics in the patients with depressed immune host-defense responses should be administered before the surgical procedure is begun. Additional antibiotics after the surgery are usually not necessary for routine extraction in healthy patients.Limitation in mouth openingTrismus results from trauma and the resulting inflammation involving the muscles of mastication.Trismus may also result from multiple injections of the local anesthetic, especially if the injections have penetrated muscles.TrismusBlood in the submucosal or subcutaneous tissues is known as ecchymosis.Onset of ecchymosis is 2 to 4 days afte surgery, and resolves within 7 to 10 days.Ecchymosis All patients seen by novice surgeons should be given a return appointment so that the surgeon can check the patient's progress after the surgery and learn the appearance of a normally healing socket.POSTOPERATIVE FOllOW-UPOPERATIVE NOTEElements of an Operative Note1. Date2. Patient name and identification3. Diagnosis of problem to be managed surgically4. Review of medical history, medications, and vital signs5. Oral examination6. Anesthesia (amount used)7. Procedure (including description of surgery and complications)8. Discharge instructions9. Medications prescribed and their amounts (or attach copy ofprescription)10. Need for follow-up appointment11. Signature (legible or printed underneath)THANK YOU