Parotidectomy Post-op Instructions

You have had a portion of your parotid removed for treatment of a parotid tumor. This was sent to pathology for evaluation. Results will be discussed when available; this can take 7-14 days.

After anesthesia

Review any post anesthesia instructions.
Do not drive or operate machinery for 24 hours or while taking pain medication.
Do not consume alcohol, tranquilizers, sleeping medications or any non-prescribed medication for 24 hours.
Do not make important decisions, sign any important papers, or use internet for the next 24 hours.
You should have someone with you at home for 24 hours.

Wound care

If your incision was closed with visible sutures, they will be removed after 1 week.

The incision will crust at the suture line. You can cleanse the wound with 1/2 strength hydrogen peroxide (equal parts tap water and hydrogen peroxide) and a Q-tip. Do this as needed (about once a day). You can also use mild facial soap instead.
Antibiotic ointment 2 times a day.
Keep incision dry. You can also use Vaseline before a shower or hair washing to make the water run off the wound. Dab dry gently as needed.

If your incision was closed with absorbable, buried sutures, we will not need to remove them.

The incision will be sealed and covered with Steri-strips. There is no need for wound care, cleansing, or antibiotic ointments.
You should keep the incision as dry as possible. Showering and hair washing are OK. Avoid direct shower water and submerging in a bath, hot tub, or pool. Dab dry gently.

Pain

Most patients are sent home with a narcotic pain medication. Take this as needed and as directed.
It is common that acetaminophen and ibuprofen are adequate for the pain. Acetaminophen can be started right after the procedure, but the ibuprofen should be started the next day. You can alternate between these medications.
- The maximum dose of acetaminophen in a 24-hour period is 3000 mg.
- The maximum dose of ibuprofen in a 24-hour period is 2400 mg.

Ice packs also work well for the first 2 days after surgery. Gently place ice over surgery sites as needed. Please place a thin, clean towel over skin first and then place ice bag over towel. Direct contact with the skin can cause injury. Ice for 10 minutes at a time every hour.
It is always best to taper narcotics as soon as possible if possible due to side effects: nausea and vomiting, headaches, itching, constipation, drowsiness, cognitive effects, and the addiction potential.

Activity

You need to be up and around for daily activities. It is OK to lie down when tired but refrain from staying in bed for extended periods during the day. Lack of moving around increases the risks of blood clots in the legs and pneumonia.
There should be no strenuous activity or heavy lifting (15 pounds) for 1 week.

Diet

There are no dietary restrictions. It is normal to have a sore throat. You can eat whatever is comfortable. Sore throat lozenges can be used to help the discomfort. The other pain medications will also help.

Constipation

Constipation after surgery is very common. It is caused by the anesthetic and narcotics. It is very important to stay hydrated. Drink plenty of fluids. It can be prevented with stool softeners (Metamucil, Citrucel, Colace) or laxatives (MiraLax). These are over-the-counter and do not need a prescription. Use as directed on the packaging.

Precautions and expectations

Watch for areas of swelling. This can be a fluid collection.
It is normal for the remainder of the gland to swell and be tender. Ice and pain meds will help with this.
Watch for any increasing pain, spreading redness, fever, and pus coming from the wound.
It is normal to have numbness around the incision, around the ear and earlobe, along the jaw, and around the upper neck.

When to call your doctor

Nausea: If nausea or vomiting continues beyond the day of surgery, anti-nausea medications or a change in pain medication may be needed.
Fever: 101F degrees F (38.5 deg C) or above may require increasing fluid intake or the need for antibiotics.
Dehydration: Drinking adequate fluids is essential to recovery, call if patient is not drinking enough.
Bleeding: Call the surgeon’s office if significant bleeding occurs. This may look like bloody drainage, significant swelling at the operative site, or both. Seek medical attention immediately if you have trouble swallowing, talking, or breathing.
Swelling & Pain: Call for excessive swelling and pain not responding to pain meds
Difficulty urinating If no urine in more than 6 hours, seek help at an emergency department.

Note: Some pain medications require a written prescription at the pharmacy, so call for refills before you run out of medication.

For questions, concerns, medications, or emergencies, call our office day or night.

Dr. Wolfe – (206) 838-8345

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