Your child has recently undergone cranial vault surgery and is ready for discharge home. This information sheet contains important information to help you care for your child at home.
Looking after the wound
It is normal to have some swelling and bruising, particularly around the face and eyes. By the time you are discharged home your child should be able to open both eyes. It can take quite a few weeks for the swelling to subside but will gradually become less noticeable. As the swelling reduces, you will notice many 'lumps and bumps' – this is normal and generally a result of plates and screws that become more noticeable as the swelling goes down. You may also feel some gaps in the bone which is to be expected, and will fill in over the coming weeks and months.
It is very important to wash your child’s hair regularly to reduce the risk of infection and wound problems. It is recommended to use a mild shampoo (e.g. baby shampoo), and to gently rub around the wound with a clean face washer or flannel.
As you have been shown on the ward, you should continue to apply Vaseline (or ointment that you have been provided) twice a day to the wound with a clean cotton bud. If any scabs form along the scar line, you should apply Vaseline to these to try and prevent them from getting bigger, and continue to wash the hair regularly. Always wash your hands before touching the wound or applying ointment.
The sutures used in the operation are dissolvable and do not need to be removed, you may notice they start to fall out in the weeks after surgery.
It is common to have some slight redness along the wound in the days following surgery, which is a normal part of the healing process. If the redness worsens, starts to spread outwards, or develops any discharge, you should contact us.
Pain control
You can continue to administer medications for pain relief as you have been instructed by the nurses on the ward. You should always follow the instructions on the bottle or box, and don’t exceed the recommended dose for your child’s age. After a few days, you should be able to start to reduce the amount of pain relief given until it is no longer required.
Eating and drinking
By the time you are going home your child should be tolerating a regular diet, but some children may take a week or two to fully regain their appetite. It is important they are drinking enough fluids to stay hydrated, and have their usual number of wet nappies per day.
Sleeping
You may find that your child wakes frequently overnight in the weeks following surgery. This is normal after this kind of surgery, and a hospital stay where they were out of their usual routine.
They should gradually return to their usual sleeping patterns around six weeks after surgery.
Head knocks and bumps at home
We understand that children often bump or knock their head. If it is a minor bump or fall, you should comfort them and treat them as you normally would have prior to surgery, keeping a watch to make sure they recover ok. If it is a more severe bump or fall, for example from a height, or there is an 'egg' or swelling evident, you should come to your nearest emergency department or see your local GP. Your child should not engage in any rough play or activities such as bike riding or trampoliningc until after their six to eight week review.
Return to childcare
Your child should ideally stay home from day care orcrèche until their six to eight week post-op review. If this is not possible for your circumstances, you should discuss this with your surgeon or craniofacial nurse.
Swimming
Your child should not go swimming or submerge their head in bath water until the wound is fully healed. Showers or pouring clean water over their head is fine.
Travel
There are no restrictions on flying after this surgery, however we would recommend waiting until after your six to eight week review to book a holiday.
Follow-up appointments
You will usually be seen in clinic on the Friday following your discharge from hospital. Your next review with your surgeon will be six to eight weeks following surgery.
Key points to remember
- It is normal to have some swelling and bruising around the face and eyes, this will subside gradually over the next days and weeks.
- It is very important to wash your child’s hair regularly with shampoo.
- Vaseline (or similar as instructed by your doctor or nurse) should be applied as instructed. You should continue to apply it to any scabs that persist.
- Stitches (sutures) used in the operation are dissolvable and do not need to be removed.
When to contact us
- If your child has any worsening redness or swelling around the wound
- If there is any discharge or bleeding from the wound
- Persistent fever
- Increasing pain or discomfort
- You are concerned about your child
Contact
If you have any concerns related to the wound or surgery in the days and weeks following surgery, you are welcome to contact us. If the situation is an emergency, always seek care from your local emergency department or call an ambulance.
Craniofacial Nurse Consultant: Monday–Friday (Not Wednesdays) during business hours
Telephone: 9345 6582
Email: stephanie.wards@rch.org.au
For any after-hours/weekend queries you can contact the on-call Plastic Surgery Doctor via Main Hospital Switch: 9345 5522.
If you are a private patient, you can contact your surgeon’s private rooms.
For more information
Developed by The Royal Children's Hospital Plastic and Maxillofacial Surgery department. We acknowledge the input of RCH consumers and carers.
Reviewed August 2023
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.