How many days do they stay with appendicitis: how long after they are discharged

Appendix removal

Appendicitis is an acute inflammation of the appendix of the dome of the cecum , requiring emergency surgery - appendectomy.

Surgery for appendicitis is common; the disease is rarely complicated by a secondary infectious process if treated in a timely manner. Hospital stay does not exceed 7-10 days.

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Features of appendectomy

The operation is carried out as follows:

The surgeon removes the inflamed appendage under general anesthesia; for this purpose, an incision is made in the right side. It has a slight bevel.
The operation takes no more than 40 minutes. If the appendix remains intact and its contents are not in the abdominal cavity, then lavage is not necessary.
If there is a rupture of the process, the surgeon rinses the cavity, removing the slightest contamination.
After removing the appendix, the doctor places stitches on the incision, sending the patient to the hospital ward.

How long do people stay in the hospital with appendicitis? The answer is simple: the patient will have to stay there until complete recovery in order to remain under the supervision of a doctor.

An appendectomy is performed after hardware and laboratory diagnostics. The inflamed organ is removed in several ways.

Laparotomy

The inflamed vermiform appendix of the cecum is excised by specialists through dissection of the soft tissues that are located directly above them.

Laparoscopy

In this case, a specialist can get to the appendage by making a puncture in the area of the navel and appendix of the abdominal wall. This procedure refers to abdominal surgery.

This method is the preferred method for resection of the appendix, as there is relatively little trauma and a quick recovery period.

The big advantage of laparoscopy is that the risk of complications is low, and discharge after surgery is much faster.

How long do you stay in the hospital after surgery?

Patients are interested in the question of how long they stay in the hospital after appendicitis is removed. The period of inpatient stay depends on many factors : the severity of the disease, the type of surgical intervention, the addition of complications (including postoperative ones), the nature of the sick leave (caring for a minor child). It is important to take into account the status of an adult or a child: special periods of sick leave are provided for in case of disability.

Depending on the type of intervention

The stay in the hospital also depends on the type of operation performed and the choice of intervention tactics :

drug antibacterial therapy for chronic appendicitis - no more than five days;
laparoscopic method through punctures of the abdominal cavity - 7-10 days, including the postoperative period;
abdominal surgery - up to 30 days from the moment of hospitalization.

The nature of the work activity of an adult patient who has undergone an appendectomy is of no small importance. The period of sick leave can be increased in cases of work associated with dangerous and harmful production, increased physical activity, and unfavorable working conditions (in the cold, in the heat, in the open air).

Postoperative period without complications

Patients stay in the hospital after surgery with a favorable recovery for up to seven days ; after the stitches are removed (if necessary), they are discharged on the seventh day, at which time the sick leave is closed.

If a parent is caring for a hospitalized child under 3-4 years of age, sick leave begins from the moment of hospitalization and ends with discharge from the hospital - 5-7 days.

For a parent of a disabled child, leave to care for him, regardless of age, can be increased to 30 days. Adults are discharged on days 5-7, at which time the sick leave is closed (plus or minus three days).

With complications

In case of complications after surgery, the hospital period varies from 15 to 30 days , however, according to the decision of the medical commission on the need for longer treatment (in a hospital or outpatient setting), it can be extended to a year.

Parents of children under seven years of age require sick leave for care after a complicated operation and for a long stay in hospital until the child’s condition improves and is discharged.

Children over 14 years old can be in hospital without parents and do not need constant care (by decision of the head of the department), so sick leave is issued for 3-5 days. Due to the child's disability, one of the parents may be on care leave until his or her full recovery.

How long is sick leave for adult patients who have had appendicitis with complications? Under general conditions it ranges from 15 to 30 days . The issuance of temporary disability certificates is regulated by orders of the Ministry of Health of the Russian Federation and the Ministry of Labor of the Russian Federation.

Possible complications and how to avoid them

Complications that may arise after a poorly performed operation often include:

long-term preservation of temperature (38°, sometimes higher);
suture dehiscence, compaction and hyperemia of the wound edges;
the appearance of purulent discharge;
stomach ache;
blood poisoning;
vein thrombosis;
adhesions;
respiratory and cardiovascular dysfunctions;
abscess;
deformation, protrusion of the contents of the abdominal cavity in the area of the wound - hernia.

Such complications often develop with purulent appendicitis, a spill of the contents of the inflamed appendix into the abdominal cavity. Poor healing of surgical sutures can be caused by weak immunity, and not just by doctors’ mistakes. In this case, repeat surgery may be required.

The period of standard rehabilitation after surgery for appendicitis may increase if recovery measures are carried out incorrectly or the doctor’s advice is ignored.

The patient returns home 1-2 weeks after surgery, leaves the control of doctors and is responsible for his own health. In addition to external sutures, there are also internal ones, which can come apart in a fairly long time, after discharge.

Discrepancies can be caused by:

gases in the intestines caused by poor diet;
retention of feces due to irregular bowel movements;
excess food;
increased load on the peritoneum.

Laparoscopic manipulation significantly reduces the likelihood of these complications, but it is necessary to follow the dosage of exercise and diet, and perform the recommended exercise therapy exercises after it.

When prescribing physiotherapeutic procedures, it is necessary to complete the course to the end. Local exposure improves the condition of sutures, promotes healing and resorption of scars.

After surgery for appendicitis, a course of rehabilitation is necessary so that the results of a successful surgical intervention are not jeopardized. The duration of this course largely depends on the persistence and caution of the patient and the exact implementation of the recommendations.

It is necessary to stimulate lost immunity, strengthen the muscle corset, and follow the diet. Important components of recovery are a positive attitude and help from loved ones.

The duration of the certificate of incapacity for work is determined by the nature of the disease and the legislation of the Russian Federation. The length of time an employee spends on sick leave after appendicitis depends on several reasons, including the method of performing the operation and the success of rehabilitation after it.

In some cases, sick leave can be extended, but there are regulations established by law for this. The article provides useful tips and recommendations for obtaining this document and the duration of sick leave that is required for rehabilitation.

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Recovery period

When are you discharged from the hospital after appendicitis? The recovery period after surgery depends on the technique used to perform it . If the operation is abdominal, then the total stay in the hospital can reach 15 days. With successful treatment, the time spent there rarely exceeds seven days.

In the first days after surgery

In the early postoperative period, bed rest is indicated ; it is necessary to monitor stool and general condition. Antibiotic therapy is immediately prescribed to avoid secondary infectious complications.

Early rehabilitation also includes:

gentle nutrition (slimy porridges, soups, pureed foods);
protective regime;
dressings;
taking medications.

and relatives look after the patients If he feels normal and there are no complications, he can get up the next day.

Early rehabilitation without complications takes 2-3 days . In the following days, the person is able to take care of himself.

For complications

Any surgical intervention is associated with potential risks, even if the patient is in perfect health. There are complications that arise unexpectedly during the operation.

Appendectomy can be complicated:

bleeding;
hypoxia after anesthesia;
violation of defecation, urination;
paresis of the intestines, ureters and bladder.

There is a risk of developing fistulas, thromboembolism, and sepsis due to inadequate care of the postoperative wound. Appendicitis itself can be complicated by peritonitis and sepsis.

Attention! Any complications complicate recovery; the duration of hospital stay can reach a month. Usually this period is enough for the patient to recover.

After discharge

After discharge from the hospital with improvement, the patient is registered with a dispensary with recommendations. Usually, after seven days in the hospital, the patient remains at home for another 5-7 days according to medical indications. In this case, sick leave is extended until the date established by the attending physician.

Shown at home:

treatment of the wound surface with antiseptics;
if the stitches are not removed, apply dressings twice a day;
taking antibiotics according to the prescribed therapy regimen.

At home, it is recommended to monitor the frequency of stool and urination, avoid hot baths and forceful exercise.
The patient is discharged by a surgeon at the clinic at his place of residence.

Hospital regime after discharge

After removal of appendicitis, it is also necessary to adhere to a specific diet:

1. Adults are advised to refrain from eating and drinking water for the first day; just wet your lips.

2. If the patient feels well, then after 12 hours he can drink tea or jelly and eat broth.

3. On days 2 and 3, you need to switch to fractional meals - eating small portions 5-6 times a day. The interval between them should not exceed 2.5 hours.

4. In the 1st week, you are allowed to eat only pureed soups, chicken fillet, low-fat yogurt and rice.

5. During the 2nd week, you can add vegetables, fruits and cereals to your diet.

6. After 2 months, eating flour and sweets in small quantities is allowed.

7. You can switch to a normal diet 4 months after appendix removal.

During this time, you must follow the rules:

food should be warm;
drink large amounts of water;
chew food thoroughly;
the diet must fully cover the body’s needs for microelements and vitamins;
You should not eat foods that provoke gas formation and fermentation in the gastrointestinal tract.

The diet for children should be softer than the diet for adults. Even in the first days they are allowed to eat bananas and fermented milk yoghurts. In adults, the menu is very limited in the early stages after removal of the appendix and gradually expands.

If appendicitis is accompanied by peritonitis, the diet is selected even more carefully so that food does not irritate the intestines. After the operation, the doctor will create a special diet for the first 14 days. Puree soup without potatoes and boiled porridge work well. Also eat more fruits (such as pears, apples and bananas), as the body needs to find additional resources to recover.

During rehabilitation after appendicitis removal, you can eat the following foods and dishes:

1. vegetable soups with potatoes, carrots, onions and herbs (puree soup is especially good);

2. mushrooms and vegetables;

3. lean meat (for example, chicken) and fish;

4. cereals (especially oatmeal, buckwheat and rice);

5. low-fat fermented milk products. In order not to disrupt the functioning of the stomach, they should be heated to room temperature;

6. honey, fruits and dried fruits;

7. herbal teas, compote and jelly.

After removal of appendicitis, the following should be excluded from the patient’s diet:

fatty meat broths;
smoked and salted products;
flour products;
sweet;
spices and salt.

General tips and tricks

Remember that surgery to remove appendicitis may be accompanied by complications if:

the patient did not adhere to the diet;
the patient lifted heavy objects and was subjected to other strong physical exertion;
the body has a weak muscular frame of the anterior abdominal wall;
internal inflammatory processes began.

Returning to normal exercise after appendicitis should be gradual. To do this, you need to do therapeutic exercises. The doctor can allow the first exercise on the abdominal muscles, weightlifting and gymnastics classes at least after 3 months.

Also, do not forget about the recommendations:

1. Apply anti-scar cream to the skin for rapid healing of the scar in 2-3 months.

Note!

2. Do not lie on your stomach.

3. Do not wet the scar after appendix removal. When swimming, the seam should be closed to prevent water from entering.

4. Alcohol can be consumed after 3-4 weeks.

5. It is advisable to refrain from smoking for 3 days. It is not necessary to adhere to this recommendation, although tobacco smoke has a particularly negative effect on the intestines and respiratory tract in the first days of rehabilitation.

6. You cannot have sex for 1 week. When the external sutures are removed, sexual intercourse is allowed if the abdominal cavity is not tense. Full sex is possible 3-4 weeks from the date of appendicitis surgery.

Prevention of appendicitis

To avoid appendicitis, you should follow a few simple rules:

1. Avoid infection with acute infections - typhoid fever, yersiniosis, and intestinal tuberculosis.

2. Treat constipation in a timely manner.

3. Balance your diet. Meals should be regular and provide the body with all the necessary substances.

4. Do morning exercises - a little warm-up activates the intestines.

5. Do not eat sunflower seeds with the skin on, swallow grape seeds or chewing gum. They can stick together into a lump that clogs the intestines and causes appendicitis.

When is sick leave extended?

How many days later will they be discharged if there are indications for extending the certificate of incapacity for work? Sick leave can be extended if the clinical situation meets the following requirements :

complications during and after surgery, including rehabilitation (peritonitis, sepsis, abscesses, adhesions, thrombosis);
an adult patient or child has disabled status;
difficult recovery, impaired mobility after surgery.

To extend the certificate of incapacity for work, it is recommended to contact the head of the surgical department or clinic at your place of residence. The appeal must be oral or declarative in nature in accordance with the procedures of the medical institution.

The average extension period reaches 30 days , however, in special cases, sick leave can be extended up to 12 months.

Attention! In case of prolonged sick leave against the background of persistent functional disorders, you can contact the ITU to assign a disability group. If the issue is resolved positively, the patient acquires the status of a disabled person and receives appropriate benefits.

First postoperative days

Rehabilitation after appendicitis begins with the end of surgery. The period until the day the patient is discharged is called postoperative. The first days of care for a patient after an appendectomy are provided by medical staff. After leaving anesthesia, the patient must strictly adhere to medical prescriptions. Anesthesia can affect a person in different ways, so vomiting, chills and other symptoms may occur.

Medical care

The first day, eating is prohibited. Drinking water during the first hours is not recommended. Since the right side hurts, you first need to lie only on your left side. After a day, the patient is allowed to get up, but if the operation was performed laparoscopically, they are helped to get up after 5-6 hours, and it is recommended to immediately walk a little. The incision is treated daily with antiseptic agents. In addition, it is necessary to take antibacterial drugs and other medications prescribed by the doctor. If the patient is concerned about constipation, he is given an enema.

During the first few days, the patient has an elevated body temperature. This is fine. But if the temperature lasts longer than 7 days, you should consult a doctor. It is necessary to monitor how long the right side of the abdomen and the incision site hurt. The abdomen around the wound should not hurt at all. After discharge, the patient is recommended to wear a bandage. The patient is discharged from the hospital 7–10 days after removal of the appendix, after removing the external sutures. This concludes the postoperative period after removal of appendicitis.

Throughout the patient’s stay in the hospital, doctors monitor the following procedures:

control of physiological recovery parameters;
detoxification (for example, if there was purulent appendicitis);
monitoring the patient's condition and symptoms of complications;
monitoring the condition of the suture (no bleeding).

Features of recovery after appendicitis include a number of restrictions on the usual lifestyle or bad habits.

Registration procedure

The registration of sick leave is carried out by the senior nurse of the specialized department, the head of the department or a surgeon in the clinic at the place of residence. The patient does not participate in filling out the form.

It specifies the causes of disability using special unified codes. Appendicitis corresponds to code 001 - it indicates a disease that makes it impossible to attend the workplace.

After discharge and closing of the sick leave on time, the patient takes the form and gives it to the employer, who fills out the necessary information related to calculations and information about the place of work. The sick leave code for 3-NDFL and the tax service is 2300.

The issuance of temporary disability certificates is regulated by Art. 183 of the Labor Code of the Russian Federation, by orders of the Ministry of Health and Social Development of Russia No. 624n dated June 29, 2011 and No. 31n dated January 24, 2012.

Disadvantages of laparoscopy

The shortcomings today include the following:

the need for additional staff training;
very expensive equipment;
using the method is not always possible.

Today, groups of patients who require laparoscopy have been identified. For example, if the diagnosis is unclear or for women of fertile age planning childbirth, whose gynecological problem is similar to the clinical picture of an acute abdomen.

Fact! Appendectomy without proper justification is performed in 47% of cases; in the long term, it results in adhesions and secondary infertility.

Also, laparoscopy is performed on the patient at his request (here it is necessary to take into account not only all the pros and cons, but also the qualifications of the surgeon), women with a preference for a cosmetic effect, with diabetes and obesity, when the risk of complications is increased, for children to prevent the risk of adhesions.

Rules and restrictions during rehabilitation

On the first day after surgery, patients fast . If you want to eat, you can drink thick jelly, broth with lean meat and vegetables. In the first hours after recovery from anesthesia, any drink or food is contraindicated (vomiting, asphyxia with vomit is possible). All food should be warm, at a comfortable temperature; aggressive foods with gas and high fat content are excluded.

Meals during the recovery period should be fractional, in small portions - this eliminates stagnation in the intestines, reduces the load on smooth muscles, and eliminates constipation.

also follow a few rules :

avoid visiting saunas, baths, hot baths - a warm shower is enough;
exclude exposure to ultraviolet radiation, direct sunlight (including visiting a solarium);
exclude physical activity and heavy lifting;
control stool - if you have constipation, you should take osmotic laxatives until stool passage is completely restored.

If the patient is sent home before the stitches are removed , they must undergo antiseptic treatment and bandages. An aqueous solution of Chlorhexidine, Furacilin, and Miramistin are ideal as an antiseptic.

If redness and pain appear on the wound or suture element, the wound becomes wet , your health deteriorates, or hyperthermia, you should consult a doctor. Such symptoms may indicate complications.

Set of instruments for laparoscopic surgery

The recovery period when removing appendicitis using the laparoscopic method is short. Elimination of movements is completely prohibited only for a few hours. By evening, the patient can already sit up in bed.

In the morning, the patient is allowed to walk to the dressing room on his own. But there is no need to do sprinting, because the body will fully recover only after 2 months. During this time, complete healing of the cut intestine occurs. It is strictly forbidden to lift or carry even small weights; only within 1-1.5 kg. Any efforts leading to tension and increased intra-abdominal pressure are excluded.

To carry out the operation you will need:

laparoscope;
video camera and monitor;
Light source;
insufflator, Veress needle with which carbon dioxide is injected;
electrosurgical equipment or laser for cutting tissue and coagulating blood vessels;
irrigator-aspirator for removing blood, pus, and fluid from the abdominal cavity.

In addition, you need to have scissors, forceps, clamps, four trocars of different diameters, devices for suturing or clips.

The use of laparoscopy for the diagnosis and removal of appendicitis

Laparoscopy differs from classical surgery in that all manipulations are carried out through small holes - up to 1.5 cm. Performing the operation in the traditional way requires large incisions several centimeters long with layer-by-layer dissection of tissue.

Laparoscopy is used for both diagnosis and removal of the appendix. With this method, the doctor has the opportunity to thoroughly examine the condition of the internal organs and accurately determine the location of the inflammation.

Laparoscopy often allows you to combine diagnosis and surgery, which reduces the time to remove appendicitis.

Advantages and disadvantages of this method

Laparoscopy has a number of advantages over traditional surgery:

rehabilitation takes much less time;
less tissue damage than during abdominal surgery;
aesthetic scars (small, invisible);
faster recovery of working capacity;
the patient experiences less pain, it goes away faster after the operation;
bowel function is restored sooner;
reducing the risk of complications and adhesions;
reduction of hospital stay.

The method also has negative sides. These are mainly difficulties in the work of a doctor:

depth perception is distorted;
little space to manage tools;
tactile sensations become dull;
it is more difficult to control tools and your movements;
There are a number of absolute and relative contraindications.

Why is laparoscopy prescribed?

This method is widely popular when performing gynecological operations. It is also used when other manipulations in the abdominal area are necessary.

Laparoscopy is performed in the following cases:

acute appendicitis;
a chronic form of the disease with pronounced symptoms and severe pain.

If inflammation has managed to cause peritonitis or an abscess, then abdominal surgery is indicated.

Who is laparoscopy indicated for?

There are several groups of patients for whom it is preferable to remove the appendix using the laparoscopic method:

when it is unclear during diagnosis whether it is appendicitis or another disease; in this case, diagnostic laparoscopy becomes therapeutic;
if a woman plans to become pregnant and have children in the future;
with some concomitant diseases that increase the risk of complications (suppuration, formation of adhesions, etc.), for example, diabetes mellitus or obesity;
children, as the risk of adhesions is reduced;
the patient’s desire to avoid large, rough scars (only if there are no contraindications).

Reviews

Patients give only positive reviews of the laparoscopic method of removing appendicitis and recovery after surgery. This is due to minimal complications, a short rehabilitation period and its relative simplicity. There are no rough scars on the abdomen, you can quickly return to work. There are also regretful reviews about the removal of appendicitis using the laparoscopic method, but they mainly concern the fact that not all clinics can offer laparotomy. In general, surgery is much preferable to a surgical incision.

Reviews on the removal of appendicitis using the laparoscopic method indicate that such operations simply save lives, despite the fact that the patient is very quickly discharged from the hospital.