Postoperative nursing care of orthopaedic and trauma patients is critical for optimising outcomes. The aspects of postoperative management that need to be considered in every case include:

 Systemic function

 Pain

 Protecting the surgery

 Regaining function

 Client compliance

A plan to address each of these areas should be carefully constructed, discussed fully with the client and documented in writing in the discharge instructions so that optimal outcomes can be reached.

Systemic Function

This critical part of postoperative management can be easy to overlook in light of the more visible and seemingly pertinent traumatic and surgical wounds and injuries. Carefully assessing integumentary, musculoskeletal, cardiovascular, pulmonary, neurological, gastrointestinal and urinary integrity and function is a vital part of comprehensive nursing care. This is accomplished by full, serial examinations with recording of vital parameters, as well as relevant diagnostic imaging and bloodwork as needed. Careful monitoring, recording and assessment of changes in these components of patient health are valuable tools in maximising outcomes.

Pain

Pain management is core to excellent nursing care. Appropriate pain management potentiates patient comfort, systemic function, recovery and healing. Fortunately, we have an excellent arsenal of pharmaceuticals and modalities available to help us manage pain well in our patients.

Protecting the Surgery

This aspect of patient care may be as simple as keeping an incision clean and dry or as complex as managing a tetraparetic giant-breed dog in a body cast after wobbler's surgery. The importance of the nursing components involved in protecting the surgery cannot be overemphasised. Keeping the patient, wounds and bandages clean and dry, putting on and maintaining bandages well, managing pain effectively, promoting appropriate and controlled activities and educating the client fully are all major components of protecting the surgeries we perform and the patients we perform them on.

Regaining Function

This is really what it is all about - regaining full and pain-free function. All of the components of postoperative nursing care listed above contribute to success in this all-important category. In addition, nutrition, physiotherapy and recheck evaluations with adjustments in the postoperative management protocol as needed all play important roles.

Client Compliance

Client compliance to postoperative instructions for care is another 'have to' for success. Compliance is all about communication and follow-up. Communication should be in both verbal and written forms and should be clear, definitive and instructive. The client should understand what the goals are, what defines success, what would be considered problems and what to do if problems occur. They should be given a timeline for progress and clearly understand their roles at each step in their pet's progression. Help them understand the purpose and importance of each medication, restriction and activity. Treat them like a member of their pet's healthcare team so that they will engage fully and be compliant.

We will discuss each of these aspects in a case-based format to provide examples for immediate and long-term strategies for postoperative management of orthopaedic and trauma patients.