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Post-operative instructions

Benjamin Domb, M.D.
Discharge Protocol for Hip Replacement and Resurfacing • Take 10 deep breaths each hour
• Get up and walk every hour. Walk as much as possible.
• Use walker only as needed. Progress to full weight-bearing as quickly as
• Keep incision dry until 5 days after surgery. Then may begin showering.
• Do not bathe or swim until incision completely healed.
• Home health nurse, if applicable will visit you in your home. Please share
• Home physical therapist will also visit you in your home for the first 2 weeks post-op. As soon as possible, you should transition to therapy in an outpatient physical therapy center. • Keep your post-op visit with Dr. Domb or his Physician Assistant at 10-14 days Instructions for Home Health Nurse:
• See patient once daily for 3 days, then 3x/week for 2 week. Check vital signs and • If on Lovenox in hospital, discharge on Lovenox for 2 weeks, then convert to • If normally on Coumadin at home, discharge on Lovenox and regular dose of Coumadin, discontinue Lovenox when therapeutic on Coumadin. PLEASE REQUEST PRIMARY CARE PHYSICIAN TO MANAGE COUMADIN. • Instruct on incision care, pain management, and hip precautions (posterior THAs • May get incision wet in shower 5 days after your surgery. No baths or swimming • Silver dressing may stay on for 7 days. Only remove if need for incision checks. • Let steri-strips fall off on their own. • Patient should return to Dr. Domb’s office for incision check at day 10-14 • Also patient should follow up with Dr. Domb at 14 weeks post-op. • Anti –embolism stockings to be worn for 4 weeks.
Instructions for Home Physical Therapy:
• See patient for 3x per week until able to transition to outpatient PT center. Please encourage transition to outpatient PT center as soon as possible. • Weight bear as tolerate, unless otherwise stated. • May obtain a rolling walker, raised toilet seat and /or any other assistive device if • Instruct on hip precautions (posterior THA only) and on home safety. • Increase mobility with gait training, transfers, and stair climbing. • DO NOT DRIVE UNTIL CLEARED BY MD. If Discharged to Skilled Nursing Facility or Rehabilitation Facility: • Physical therapy twice daily & Occupational therapy to evaluate. • If on Lovenox in hospital, discharge on Lovenox for 2 weeks, then convert to • If normally on Coumadin at home, discharge on Lovenox and regular dose of Coumadin, discontinue Lovenox when therapeutic on Coumadin. PLEASE REQUEST PRIMARY CARE PHYSICIAN TO MANAGE COUMADIN. • Instruct patientt on incision care, pain management, and hip or knee precautions. • May get incision wet in shower day 5 after surgery. No baths or swimming until • Silver dressing may stay on for 7 days. Only remove if need for incision checks. • Let steri-strips fall off on their own. • Patient should return to Dr. Domb’s office for incision check at day 10-14 • Also patient should follow up with Dr. Domb at 14 weeks post-op. • Anti –embolism stocking to be worn for 4 weeks. R.N: Please fax to rehabilitation center or Home Health Agency For questions, please email call 630-455-7130.

Source: http://www.benjamindombmd.com/wp-content/uploads/2011/06/post-op-tha-bhr-new.pdf

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