The Importance of Coughing and Deep Breathing After Surgery
Following a surgical procedure, especially those involving the chest or abdomen, the body's natural respiratory functions can be affected. Anesthesia and pain medication can depress breathing, and the patient may be reluctant to take deep breaths or cough due to the discomfort at the incision site. However, deep breathing and coughing are crucial for expanding the lungs and clearing any mucus that may have settled during the procedure. Without these exercises, there is an increased risk of developing atelectasis (a collapsed lung) or pneumonia. Supported coughing is a proactive measure to prevent these serious complications by ensuring the lungs stay clear and healthy throughout the recovery process.
What is Pillow Splinting?
Pillow splinting, or respiratory splinting, is the technique of applying firm, consistent pressure to a surgical incision with a pillow or rolled blanket while performing deep breathing or coughing exercises. This technique provides crucial support to the wound and surrounding tissues, which minimizes the sudden, jarring motion caused by a cough. By stabilizing the area, the splinting technique reduces pain and prevents excessive stress on the incision, lowering the risk of it opening. While most commonly used for abdominal and chest surgeries, it can also be beneficial for other incision sites to help manage discomfort during body movements.
How to Use a Pillow to Cough After Surgery
Using a pillow correctly for splinting is key to its effectiveness. A good technique ensures maximum comfort and protection for your incision.
Preparing for the Cough
Before attempting to cough, prepare yourself and the pillow. Choose a pillow that is firm enough to provide support but soft enough to be comfortable. Position yourself either sitting upright on the edge of the bed or in a chair. Bending your body slightly forward can help position your abdominal muscles for the exercise.
The Proper Bracing Technique
To brace your incision, follow these steps:
- Position the pillow: Place the pillow or a firmly rolled-up blanket directly over your incision site, covering the entire area.
- Hug it tight: Hold the pillow or blanket firmly against your body, applying gentle but firm pressure with your hands. The goal is to hold the incision in place and prevent it from moving with the force of the cough.
- Take a deep breath: Inhale slowly and deeply through your nose, expanding your lungs completely. Hold this breath for about five seconds.
The Coughing Action
After holding your breath, perform the cough:
- Cough forcefully: Release the air from your lungs with a firm, single cough. The pillow should absorb the shock of the cough.
- Repeat as needed: Depending on your provider's instructions, you may need to repeat the process. If mucus comes up, spit it into a tissue.
- Pace yourself: Take breaks if you become tired. Regular, supported coughing is more effective than infrequent, painful attempts.
Comparison of Incision Support Methods
Various methods can be used for splinting, each with different considerations. Your healthcare provider may recommend a specific type depending on your procedure.
| Feature | Pillow | Hands | Specialized Heart Pillow |
|---|---|---|---|
| Availability | Widely available and easily accessible in a hospital or at home. | Always available, no special equipment needed. | Often provided by hospitals for specific procedures (e.g., open heart surgery). |
| Firmness | Varies depending on the pillow. A firm, dense pillow is ideal. | Pressure can be adjusted directly by the user. | Specifically designed to be firm and provide optimal pressure for chest incisions. |
| Effectiveness | Highly effective for supporting abdominal and chest incisions. | Useful as a quick alternative, but can be less stable than a pillow. | Shaped to fit the chest area perfectly, providing superior support for heart surgery patients. |
| Key Benefit | Versatile, comfortable, and provides broad coverage for the incision area. | Convenient for immediate support when a pillow isn't nearby. | Engineered for maximum protection and comfort following open heart surgery. |
When to Use and When to Stop Pillow Splinting
Typically, splinting with a pillow is most necessary in the immediate days and weeks following surgery, when the incision is most sensitive and susceptible to pressure. The need for splinting will decrease as your incision heals and the pain subsides. It is important to follow your surgeon's specific recommendations for how long to continue this practice. For some, it might be a few weeks, while for others, especially those with larger incisions like from open heart surgery, it could be longer. Always consult your healthcare provider before deciding to discontinue the practice, especially if you have an upcoming action that could put stress on your incision, such as lifting or strenuous activity.
Additional Breathing and Coughing Tips
While pillow splinting is a crucial technique, it is often part of a broader respiratory care plan. Your nurse or respiratory therapist may also advise the following:
- Use an incentive spirometer: This device is designed to help you take slow, deep breaths to expand your lungs. It is a key tool in preventing lung complications.
- Combine with deep breathing: Alternate your supported coughing exercises with regular deep breathing. Inhale deeply, hold, and then exhale slowly. This helps keep the airways clear and lungs inflated.
- Get moving: Early mobilization, such as walking, can significantly improve lung function and overall recovery.
- Hydrate: Drinking plenty of fluids helps to thin mucus, making it easier to cough up and clear from your lungs.
Conclusion
For many patients, the simple act of using a pillow to cough after surgery is a powerful tool for managing pain and protecting the surgical site. By providing firm support, this technique reduces the strain on your incision during movements like coughing, laughing, and sneezing. It is a fundamental part of post-operative care, aiding in your recovery by helping to prevent pulmonary complications like pneumonia. Always adhere to your healthcare provider's instructions for the safest and most effective recovery. For more information, read this article on how to cough after surgery.
