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Discharge Instructions for Open Splenectomy (Pediatric)

Your child had an open splenectomy. During the procedure, your child’s spleen was surgically removed because it wasn’t working correctly. The spleen is in the upper left part of the belly. It helps protect the body from infection. To remove your child’s unhealthy spleen, the healthcare provider made a large cut (incision) in your child’s belly. Here’s what you need to know about caring for your child at home after surgery.

Incision care

Follow this advice to care for your child's incision:

  • Check your child’s incision daily for redness, swelling, or separation of the skin.

  • Let your child shower as needed. But don't let your child swim or sit in a bathtub or hot tub until the healthcare provider says it’s OK to do so. This helps prevent infection of the incision site.

  • Keep your child’s incision clean and dry. Wash the incision gently with mild soap and warm water. Then gently pat the incision dry with a towel.

  • Don't remove the white strips from your child’s incision. Let the strips fall off on their own. You may trim the edges if they start to peel.

Limit activity

Tips include:

  • Show your child how to climb steps slowly and stop to rest every few steps. Limit stair climbing to once or twice a day.

  • Don’t let your child lift anything heavier than 3 pounds. This is to prevent straining the incisions.

  • Give your child a break from chores that take physical effort, such as vacuuming or mowing the lawn. Wait until the healthcare provider says it’s OK.

Other home care

Follow this general care advice for your child:

  • Give your child pain medicines as directed by the healthcare provider.

  • Have your child finish all of the antibiotics the healthcare provider prescribed, even if he or she feels better. Antibiotics help protect your child from infection.

  • Check your child’s temperature every day for 1 week after the surgery.

  • Get medical care even for mild illnesses such as colds or sinus problems. It’s important to do this because without a spleen, your child is more likely to get an infection.

  • Tell all of your child’s healthcare providers—including the dentist—that your child does not have a spleen.

  • Think about getting a medical identification bracelet for your child that says he or she does not have a spleen.

  • Talk with your healthcare provider about vaccines. Your child will be more likely to get an infection after the surgery. Specifically, ask about pneumococcus, meningococcal, haemophilus, and flu vaccines.

  • If your child gets constipated, talk with the provider about a plan called a bowel regimen. Pain medicines can be constipating. More fiber, water, and a stool softener are often helpful.

Follow-up

Make a follow-up appointment as directed.

When to call your child’s healthcare provider

Call the healthcare provider right away if your child has any of these:

  • Fever (see "Fever in children," below)

  • Shaking chills

  • Feeling dizzy or lightheaded

  • Any abnormal bleeding

  • Redness, swelling, warmth, fluid drainage or pain at the incision site

  • Incision site that opens up or pulls apart

  • Belly pain or vomiting

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider.

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider.

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider.

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider.

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider.

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

Online Medical Reviewer: Jen Lehrer MD
Online Medical Reviewer: John Hanrahan MD
Online Medical Reviewer: L Renee Watson MSN RN
Date Last Reviewed: 8/1/2019
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