Leaving hospital after craniofacial surgery

Your child has recently had craniofacial surgery. We are happy that your child has now recovered from their operation and is ready to go home.This page from Great Ormond Street Hospital (GOSH) is designed to give you the advice and support you need when you take your child home. Please use the advice in this information sheet in discussion with your nurse. If you have any questions or concerns once you go home, you should contact your nurse for further help.

Swelling and bruising is normal after this type of operation, particularly around the face and eyes. It can sometimes appear worse in the morning or after your child has been lying down.

It can take a few weeks for all the swelling to go down. During this time, try to stop your child rubbing their eyes, as it can cause soreness or risk infection.

If the wound starts to look swollen or red, or begins to ooze, contact your nurse for advice.

The stitches your child has are dissolvable and can take several weeks to go. You may find that they will begin to fall out when you wash or brush your child's hair.

You should wash your child's hair every other day with a mild baby shampoo (do not use conditioner). Gently rub over the wound with a clean flannel. Avoid scratching the wound and brush the hair gently.

Sometimes you may notice scabs forming along the scar-line. This is normal. You can prevent them from becoming too big by gently rubbing Vaseline® onto the scab after you have washed the hair.

If the scab starts to look like the photo in the information sheet, gets larger or starts to smell, call your nurse

You should avoid allowing the scar to become sunburnt. If the weather is sunny, use a good sun block and keep your child's head covered with a hat.

Some children may still be sore for a few days after discharge, this should gradually ease off. Paracetamol/Ibuprofen should control the pain. Follow the manufacturer’s instructions on the box or bottle. Do not exceed the recommended dose for your child's age. If the pain does not go away, or increases, and you are concerned, please contact your nurse for advice.

Knocks and bumps are a normal part of childhood life. It is not necessary to be too protective; a simple fall will not be too harmful. However, rough-and-tumble play should be avoided. If your child has a severe fall or bang, then take them to your local urgent care centre or Accident and Emergency (A&E) department just as you would for any other child.

Depending on your child's operation, they may need time off from school or playgroup. Sometimes this may be for up to a few weeks. You should discuss this with the nurse before you go home.

When your child returns to school or nursery, you may need to ease them back in gently. Start with a few mornings, then begin to increase the time as they recover their energy.

If your child attends a nursery/parent-and-toddlers group, it is best not to attend for about a week, to prevent them coming into contact with infections.

School-age children should avoid contact sports or bike-riding until reviewed by their doctor in clinic. Swimming should be avoided for a month after the operation, or until the wound has healed and all the stitches are gone.

If your child is due any immunisations around the time of surgery, you should just check with your nurse to ensure it is alright to carry on with them.

It is safe for your child to fly after the operation. If you are planning a holiday, please let your doctor know before booking or making reservations.

A follow-up appointment will be made before your child is discharged. If this is not convenient, please let us know in advance.

It is important that we monitor your child's progress, so please make sure you and your child attend the appointment.

When washing your child's hair you may feel the springs just under the skin. They can be slightly visible and this is normal. If the skin over them becomes red or raised then please contact the nurse specialist to discuss it.

Very rarely do they protrude through the skin but if this happens it is usually a very small open area and you may see some ooze coming from it – if this happens please contact the nurse specialist.

As the springs open up, they can cause unevenness of the skull, one side can look more prominent than the other and this can happen suddenly and look a little unusual. This is normal, as are lumps and bumps around the skull during this time.

This usually resolves itself over the coming months once the springs have stopped expanding.