Posts Tagged pain pump
Tummy Tuck surgery is almost invariably greatly appreciated by the proper patient. These top ten facts might help you figure if you are such a person.
(1) Tummy Tuck surgery is one of the largest scale operations a plastic surgeon can offer a patient.
(2) Patients who have lost a good deal of weight or completed child bearing involving large weight gain and loss are the most common candidates. Patients do not lose much weight from the operation itself in most cases….maybe a few pounds on average.
(3) Post-operative pain used to make it necessary to admit the patient to a hospital for narcotics.
(4) Pain pumps when properly utilized can decrease pain significantly. Overnight stays often reduce risk when properly supervised.
(5) Revisions are not uncommon but can often be done in a lower key environment….such as local in the office. The revision rate varies enormously between surgeons.
(6) All tummy tucks are not alike. The work of the novice really shows in this operation.
(7) Many physicians in the OC offer these operations including plastic surgeons, cosmetic surgeons, gynecologists and general surgeons. You guess which ones look the best?
(8) When you go to the bargain basement doctor, some of what may happen may not be correctable later.
(9) Drains and pump catheters will need to be used for a week or longer. They reduce risk of fluid collections that can ruin otherwise nice results (My opinion of course.)
(10) Smoking can really impair healing and lead to skin necrosis which commonly detracts from the quality of the result and delays wound healing sometimes for months. Don’t have the surgery if you can’t stop the cigarettes and tell your surgeon a true indication of how many cigarettes you are smoking daily.
John Di Saia, M.D.
Originally posted 2011-04-20 07:30:15.
About ten years ago plastic surgery had a nice little advance, the advent of the disposable pain pump. Breakthroughs in medicine are far fewer than advertising copy would have you believe, but this one is real. Unfortunately some practices use them like a marketing ploy in all cases and really don’t spend the time to make them work well or minimize their risk. Others don’t see the benefit and don’t use them at all.
Pain pumps are quite useful in some cases when used correctly. Plastic surgery is a technical specialty and some surgeons are more adept at making things work than others. There are risks with them and cases in which the benefit is harder to measure.
How Does a Pain Pump Work?
These pain pumps are disposable devices that pump a local anesthetic into areas of a wound at which pain is best minimized. The anesthetic numbs the painful area greatly diminishing pain produced there. It is like cutting the flow of air to a fire. The fire burns less well or stops burning entirely. This amounts to less pain…sometimes a lot less.
Is There Any Risk With a Pain Pump?
Of course there is. By pumping too much fluid into the wound for too long, the wound can be delayed in closure or by the formation of a fluid pocket called seroma. These can be big issues in plastic surgery. So your doctor needs to regulate both the use time and the volume of fluid pumped into the wound. This risk can be made minimal by proper management.
In What Kinds Of Surgery is a Pain Pump Useful?
I use them in Tummy Tuck surgery mainly for the first 4-6 days at low volume. In these cases they greatly decrease pain making oral narcotics use much less necessary. When I did my wife’s tummy tuck you better believe I used one of these babies.
John Di Saia MD
Five hours after her tummy tuck, Kim’s condition is a credit to modern pain pump design and placement. She is awake and taking relatively little pain medication at home 5 hours after a large scale tummy tuck with a muscle repair. Before pain pump development, she would have been much more uncomfortable in a hospital bed during this same post-operative period taking intravenous narcotics. She updates you on her medications, pain and drains.
John Di Saia MD
Believe it or not, a major source of pre-operative dismay with tummy tuck patients is on the issue of drains.
Tummy Tuck patients need drains. Drains help decrease the potential for seroma formation (fluid collecting between the skin flap and muscle). Seromas can really make post-operative care difficult especially if they become infected. The judicious use of drains really decreases the potential for seromas.
Personally, I use drains until fluid output pretty much ceases. This is usually 1-2 weeks. Larger cases/patients can require them longer. Other surgeons don’t use them or remove them sooner and tolerate a higher risk of seromas. This is a matter of opinion. Their patients seem to end up with less flattened tummies than mine. I do what I do with reason.
Here is an close-up of one of my tummy tuck patients five days from her surgery. The drains are the tubes leading to the larger bulbs at her sides. The thinner tube toward the center is her pain pump catheter.
The drains really don’t cause much discomfort although they are unsightly and patients usually are relieved when they are removed.
John Di Saia MD
Originally posted 2005-05-12 21:20:00.