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 properly. Located in the upper left portion of the belly, the spleen helps protect the body from infection. To remove your child’s unhealthy spleen, the healthcare provider made a large incision in your child’s belly. Here’s what you need to know about caring for your child at home following surgery.
Recommendations for care of your child's incision include the following:
Check your child’s incisions daily for redness, swelling, or separation of the skin.
Allow your child to shower as needed. But do not allow him or her to 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.
Do not remove the white strips from your child’s incision. Let the strips fall off on their own.
Tips include the following:
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 allow your child to lift anything heavier than 3 pounds to avoid straining the incisions.
Give your child a break from chores that involve physical effort, such as vacuuming or mowing the lawn, until the healthcare provider says it’s OK.
Other home care
Recommendations for home care of your child's incision include the following:
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(s) after the surgery.
Get medical attention even for mild illnesses such as colds or sinus problems. It’s important to do this because without a spleen, your child is more prone to infection.
Be sure to tell all of your child’s healthcare providers—including the dentist—that your child does not have a spleen.
Consider getting a medical identification bracelet for your child that says he or she does not have a spleen.
Talk to your healthcare provider about vaccines. Your child will be more prone to infection after the surgery. Specifically, ask about pneumovax, meningococcal, haemophilus, and flu vaccines.
Make a follow-up appointment as directed by our staff.
When to call your child’s healthcare provider
Call the healthcare provider right away if your child has any of the following:
Fever (see Fever in children, below)
Dizziness or lightheadedness
Any unusual bleeding
Redness, swelling, warmth, 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.
March 21, 2017
Fever in infants and children: Pathophysiology and management. UpToDate
Adler, Liora C., MD,Fraser, Marianne, MSN, RN,Turley, Ray, BSN, MSN