The following information is to help you better understand the process when your child is coming to hospital for Craniofacial surgery.
Prior to surgery
Once your child has been diagnosed with a craniofacial condition requiring surgery, you will need to attend a number of appointments in the lead up to surgery. These appointments may include:
- CT scan: This will usually be organised to be done at the RCH prior to surgery. Often due to a child’s age, this will be done under sedation or a general anaesthetic.
- Neurosurgery appointment: You will need to meet with the neurosurgeon who will be involved in your child’s surgery. You may see them in a craniofacial/neurosurgery clinic, or as a separate appointment in the Neurosurgery Department.
- Ophthalmology appointment: Your child will be referred to see an Ophthalmologist (eye doctor) doctor prior to surgery.
- Genetics: Your surgeon may refer you to see a geneticist if they feel it is appropriate.
- Pre-Admission Clinic: Your child may be referred to attend the pre-admission clinic to be assessed by an anaesthetist prior to surgery.
- Plastic Surgery clinic: You will have an appointment with your surgeon again close to the time of surgery. They will answer any questions you might have at this stage.
- Medical Photography: Your child will need to attend the hospital one to two weeks prior to surgery to have some 3D photos taken. A craniofacial nurse consultant will provide forms for these.
- Blood test: Your child will need to attend the hospital one to two weeks prior to surgery to have a blood test to check their overall health, and to cross match blood as they will likely need a transfusion during surgery. A craniofacial nurse consultant will provide forms for these.
Preparing for surgery
- You will receive an admission letter from the hospital usually two to four weeks prior to surgery. This will include the date of surgery, admission time, where to come to on the day of surgery, and fasting times (when to stop eating and drinking). You will be asked to call and confirm that you are accepting that date of surgery.
- Your child is usually admitted on the day of surgery. If you do not live in Melbourne, you will need to plan to come to Melbourne one to two days prior to surgery.
It is important that your child is well for the surgery. If you are concerned they have a cough, cold or other illness in the weeks prior to their surgery date, please contact your craniofacial clinical nurse consultant or pre-admission nurse to discuss.
What to bring to hospital
- Clothing for your child that buttons down the front is easier as it does not have to go over their head.
- If your child is formula fed, please bring in an unopened tin of their normal formula. This can be sent to the formula room to be prepared for you.
- A supply of nappies, although there is usually some available on the ward.
- If your child has a special toy or comfort object you are welcome to bring this along.
- Toiletries for the parent or guardian staying in hospital with your child. Towels are available on the ward.
- Sheets andblankets are available on the ward, but some parents prefer to bring their own pillow and sleeping bag.
- You may like to bring your own DVD player,laptop or iPad with you, but please be aware that you are responsible for any valuables brought onto the ward. Please remember not to leave any valuables unattended in your room.
Hospital stay
Generally your child will be in hospital for approximately five days. Both parents are welcome on the ward throughout the day, but there are strict hospital guidelines that only one parent or guardian may stay overnight.
Most patients will go to Platypus ward (Surgical Unit) on the fourth floor following their surgery. The nurses there are very experienced at looking after children who have undergone craniofacial surgery. You will most likely have a single room with a shared bathroom.
Breakfast and tea andcoffee facilities are provided for parents on the ward, however no other meals are provided unless you are a breastfeeding mother. There is a fridge available in the parent lounge where you can store clearly labelled food, or there are a number of cafes andfood outlets within the hospital where you can purchase meals or food. Age appropriate meals will be provided for your child.
Ward visiting hours are 10am to 12pm and 2pm to 8pm.
On admission
Your child will usually be admitted to hospital at 7am on the day of surgery. Your admission letter will contain details regarding where to go on the day (Surgical Reception J, third floor, via the yellow lift).
You and your child will be seen by a nurse who will complete the admission paperwork, and perform a final health check. You will also see the anaesthetist, and the surgeons who will be able to answer any last minute questions that you have. Shortly before surgery you will be taken to an area near the operating theatre called ‘Pre-op hold’. Both parents orguardians are welcome in this area.
When it is time to go into theatre, one parent or guardian is able to come into the room with the anaesthetist where your child will ‘go to sleep’. Once they are asleep, you will be shown to the waiting room, which is located just outside the operating theatres. As the operation is likely to take some hours, we encourage you to go for a walk or have some lunch or a coffee downstairs. Your surgeon will take your mobile number and will let you know an approximate time to return to the waiting room.
After surgery
- Once surgery is completed, the surgeons will come and find you in the waiting room, or will call you on your mobile phone.
- You will be called through to the recovery room when your child is starting to wake up and the nurses are satisfied that they are stable.
- Your child will have IV lines attached which will be giving them fluids, pain relief, antibiotics or other medication. They may have a urinary catheter in to monitor their urine output. You are able to hold and comfort your child straight away. The nursing staff will be able to help you pick up and position your child.
- Once your child is awake and settled, they will be transferred to the ward. The nursing staff will closely monitor your child, and will frequently check their condition. This can be frustrating when you are trying to get some sleep during the night, but is very important to ensure your child is recovering well.
- Your child may eat and drink as soon as they feel like it. Sometimes they can feel nauseous from the pain relief they are receiving, and can be given some medication to help with this.
- Your child will be seen by the doctors each morning. The Children’s Pain Management Service (CPMS) will visit your child each day while they have IV pain relief running.
- The fluids and pain relief your child is receiving will be gradually decreased. They will then be given oral pain relief, and fluids can be turned off once they are eating and drinking sufficient amounts.
- Your child is likely to develop swelling around the head and eyes. This can sometimes cause the eyes to swell shut, but children tend to tolerate this well and it usually improves within a couple of days.
- You can be discharged from hospital once your child is eating and drinking sufficient amounts, their pain is well controlled with oral pain relief, and the swelling has reduced enough that they can open both eyes. This is usually around five days post-surgery.
After discharge
- You will have an appointment with your child’s surgeon usually around five to seven days following your discharge from hospital. If you don’t live in Melbourne, you should arrange to stay locally until this appointment. You will then have another appointment at six weeks post operatively, six months, and 12 months. After this the appointments will be less frequent but we will continue to review your child regularly until they are a teenager.
- Sutures are dissolvable and don’t need to be removed. It is important to keep your child’s hair clean with regular washing, and apply any ointment orcream as instructed.
- If you notice the wound looks red or inflamed, if there is bleeding or discharge, or your child develops a temperature over 37.5 degrees, please contact your craniofacial nurse consultant or the plastic surgery registrar on call.
- It is important during the first six weeks after surgery to try and protect your child from falls and injuries. After six weeks they are generally fine to return to normal activity, including day care.
Other useful information
Vaccinations at 12 months of age: It is important to note, that as your child is likely to receive a blood transfusion in surgery, this will impact their 12-month vaccinations if they haven’t already received them. The Measles Mumps Rubella (MMR) vaccination will need to be delayed (usually by five months) after a blood transfusion, however the other 12 month vaccinations can be given as per normal. This is because the low levels of antibodies that may be present in the blood product may impair the immune response to the live vaccine. Please contact the RCH immunisation centre to discuss further if needed.
Victorian Patient Travel Assistance Scheme: The Victorian Patient Transport Assistance Scheme (VPTAS) covers some costs incurred when you travel more than 100kms one way for specialist medical treatment. Each state in Australia has a similar scheme so it is worthwhile checking this before you travel.
Contact
- Craniofacial Clinical Nurse Consultant: 9345 6582
- Platypus Ward: 9345 5432
- Plastics on-call Doctor: 9345 5522
- Specialist Clinic Appointments: 9345 6180
- Pre-Admission Clinic: 9345 4193
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.