Craniosynostosis repair - discharge
Craniectomy - discharge; Synostectomy - discharge; Strip craniectomy - discharge; Endoscopy-assisted craniectomy - discharge; Sagittal craniectomy - discharge; Frontal-orbital advancement - discharge; FOA - discharge
When Your Child Was in the Hospital
Your child was in the hospital to have the connections between bones in their skull repaired. These connections are called sutures. When a baby is born, it is normal for these sutures to be open a little. This gives the baby’s brain and head room to grow.
Your baby was born with craniosynostosis, a condition that caused 1 or more of your baby’s sutures to close too early. This can cause the shape of your baby’s head to be different than normal. Sometimes it can cause brain damage.
If your child had an open repair, the surgeon made an incision (a cut made during surgery) over part of their scalp. Pieces of bone were probably removed. The surgeon either reshaped these bone pieces and put them back in or left the pieces out.
A plate and some small screws were put in place to help hold the bones in the right position. There was probablya lot of swelling on your child’s head and around their eyes when they were in the hospital.
If your child had their repair done with an endoscope, only 2 small cuts were made in their scalp. Bone was removed as needed.
What to Expect at Home
Most times, swelling and bruising will get better after 7 days. But swelling around your child’s eyes may come and go for up to 3 weeks.
Your child’s sleeping patterns may be different when they first come home from the hospital. They may be awake at night and asleep during the day.
It is very important to protect your child’s head from injury. They should not go to school or daycare for at least 2 to 3 weeks after the surgery. See also: Preventing head injuries in children
At home, your child will probably be able to return to their normal activities and diet. Make sure they do not bump or hurt their head in any way. If they are crawling, you may want to keep coffee tables and furniture with sharp edges out of the way until they recover.
In bed, raise your child’s head on a pillow. This will help prevent swelling around the face. Try to get your child to sleep on their back. All swelling from the surgery should go away in about 3 weeks.
Keep your child’s surgery wound clean and dry until the doctor says you can wash it. Do not use any lotions, gels, or cream to rinse your child’s head until their skin is healed all the way. Do not soak the wound in water until it heals.
When you clean the wound, make sure you:
- Wash your hands before you start.
- Use a clean, soft washcloth.
- Dampen the washcloth, and use antibacterial soap.
- Clean in a gentle circular motion. Go from one end of the wound to the other.
- Rinse the washcloth well to remove the soap. Then repeat the cleaning motion to rinse the wound.
- Gently pat the wound dry with a clean towel or a dry washcloth.
- Use a small amount of ointment on the wound as recommended by the child's doctor.
- Wash your hands when you finish.
Use acetaminophen (Tylenol) as your child’s doctor advises, to help control your child’s pain. Cover the scar with sunscreen or have your child wear a hat that covers the scar for the first year after surgery. This will prevent it from turning dark.
When to Call the Doctor
Call your doctor if:
- Your child’s temperature is higher than 101.5 ºF.
- The surgery wound is red, swollen, warm, or more painful.
- There is pus, bleeding, or other drainage from the wound.
- Your child is vomiting and cannot keep food down.
- Your child is more fussy or sleepy.
- Your child seems confused.
- Your child is acting like they have a headache.
- Your child’s head is injured.
Kanev PM. Congenital malformations of the skull and meninges. Otolaryngol Clin North Am. 2007 Feb;40(1):9-26, v.
Baskin JZ, Tatum III, SA. Craniofacial surgery for congenital and acquired deforminities. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 185.
Shabir Bhimji MD, PhD, Pediatric and General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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