Proximal Hamstring Repair

Nicholas K. Sablan, M.D.

Printable Version of the Post=Op Instructions 

 

Post Operative Instructions after Proximal Hamstring Repair  

Helpful Hints & Important Precautions for Patients 

Diet 

  • You may resume clear liquids and light foods after surgery (jello, soup, etc.) 
  • Progress to your normal diet as tolerated as long as you are not nauseated. 

Medications: 

  • Before surgery, you will likely receive a nerve block that will last about 8 to 24 hours. It is important to take your pain pills before this medicine wears off. 
  • The first medication I use is Percocet (Oxycodone/Acetaminophen), which is a strong narcotic pain medication. It will begin to work within 15 minutes after taking it, with a maximal effect in one to two hours. Normally, Percocet is taken 1 pill every 6 hours, but if the pain is severe, 2 pills can be used every 4 hours. 
  • Common side effects of the medications are nausea, constipation, itching, and drowsiness. 
  • The best way to prevent nausea is to take the medicine with a little food, start with just one pill, and be patient while the medicine begins to work. Usually, after the first few doses, the nausea will go away. I also prescribe an anti-nausea medication called Zofran (Odansetron) to be taken if you have persistent nausea after surgery. 
  • You will also be given a prescription for Naprosyn which is a strong anti-inflammatory medication. Take this twice a day with food in addition to the Percocet. Both medications with work synergistically in pain relief. 
  • I strongly recommend you take an over-the-counter stool softener starting the day of surgery such as Colace 100 mg 1 tablet a day and a laxative such as Miralax to avoid constipation. 
  • Take Benadryl one half hour before your narcotic if you experience itching. 
  • Do not drive or operate heavy machinery while taking Percocet or other narcotics. 
  • You should take 325 mg Enteric coated Aspirin once a day for two weeks to help prevent blood clot formation. 
  •  Transition to Tylenol as your pain subsides, but pay attention to the dosage as Percocet has 325 mg of Tylenol in each pill. Patients with normal liver function should not consume more than 3000 mg of Tylenol per day. 
  • All non-narcotic medications will be called into your pharmacy prior to surgery.

Bandages & Sling: 

Your post-operative dressing has two layers you need to understand in order to properly care for your surgery site. Your incisons were closed with nonabsorbable stitches and an adhesive glue. Your stitches should be left in place until I see you at your first post-operative date. 

The second layer is an Aquacel dressing that is maintained in place until your first postoperative visit. 

Keep the compression stocking on at all times aside from showering until the first post- operative visit. 

As the surgery is irrigated with large amounts of fluid, occasionally there will be a small amount of blood mixed with water in this dressing. This is nothing to worry about, however if you see a lot of bleeding please call Dr. Sablan. 

Washing & Bathing: 

  • You should be careful to keep the wound covered with the Aquacel dressing until your first postoperative visit. 
  • It is OK to go into a swimming pool after the first post-operative visit, but no lakes or ocean until two weeks after surgery. 

Ice & Activity: 

  • One important goal following surgery is to minimize swelling around your surgery site. The best way to achieve this is with the frequent application of ice. This is most important during the first 48 hours following surgery. The ice pack should be large (like a big zip-lock bag or bag of peas) and held firmly on the area of your surgery. Apply for 15 minutes every hour while awake if possible.
  • Crutches will be given to you before surgery if you do not have them already. Use the crutches at all times before the first visit if you are up walking. 
  • A knee scooter can be provided to help you get around if needed.  
  • You will have a brace locked in full flexion(bent). Do not change the hinge settings until directed by Dr. Sablan. The brace is worn at all times except when showering. 
  • You are typically to remain non-weight-bearing for 4 weeks with crutches. 
  • You may return to sedentary work only or school in 7 days after surgery if your pain is tolerable. 
  • Avoid long-distance traveling in cars or by airplane during the first week after surgery to avoid increasing your risk of developing blood clots. 

Exercises 

  • Move your ankle back and forth many times during the day to help your circulation. 

Physical Therapy 

  • The goal of physical therapy is to first assess how your body responded to the surgical procedure. They help you feel comfortable with your surgery and make sure you aren't afraid to start doing things. Your therapist will start range of motion and strength exercises after your first visit. 
  • You will start physical therapy after your first post-operative visit. 

 Follow-up appointment: 

  • We try to give all our patients a follow-up office visit at the same time we schedule your surgery. 
  • Typically I want to see my patients in the office 5 to 7 days after surgery. 
Nicholas K. Sablan, M.D.
postoperative instructions