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Craniosynostosis repair - discharge

Craniectomy - child - discharge; Synostectomy - discharge; Strip craniectomy - discharge; Endoscopy-assisted craniectomy - discharge; Sagittal craniectomy - discharge; Frontal-orbital advancement - discharge; FOA - discharge

When your child was in the hospital

Your baby was born with craniosynostosis, a condition that causes 1 or more of your baby's skull sutures to close too early. This can cause the shape of your baby's head to be different than normal. Sometimes it can slow normal brain development.

During surgery:

  • The surgeon made 2 to 3 small cuts (incisions) on your baby's scalp.
  • Pieces of abnormal bone were removed.
  • The surgeon either reshaped these bone pieces and put them back in, or left the pieces out.
  • A plate and some small screws were put in place to help hold the bones in the right position.

What to expect at home

Swelling and bruising on your baby's head will get better after 7 days. But swelling around the eyes may come and go for up to 3 weeks.

Your baby's sleeping patterns may be different after getting home from the hospital. Your baby may be awake at night and sleep during the day. This should go away as your he or she gets used to being at home.

Self-care

Your baby's surgeon may prescribe a special helmet to be worn, starting 3 weeks after the surgery. This helmet has to be worn to help further correct the shape of your baby's head.

  • The helmet needs to be worn every day for the first year after surgery.
  • It has to be worn at least 23 hours a day. It can be removed during bathing.
  • Even if your child is sleeping or playing, the child needs to wear the helmet.

Your child should not go to school or daycare for at least 2 to 3 weeks after the surgery.

You will be taught how to use a tape to measure your child's head size. You should do this on a weekly basis.

At home, your child will probably be able to return to normal activities and diet. Make sure your child does not bump or hurt his or her head in any way. If your child is crawling, you may want to keep coffee tables and furniture with sharp edges out of the way until your child recovers.

In bed, raise your child's head on a pillow. This will help prevent swelling around the face. Try to get your child to sleep on his or her back.

Swelling from the surgery should go away in about 3 weeks.

To help control your child's pain, use children's acetaminophen (Tylenol) as your child's doctor advises.

Wound care

Keep your child's surgery wound clean and dry until the doctor says you can wash it. Do not use any lotions, gels, or cream to rinse your child's head until the skin has completely healed. Do not soak the wound in water until it heals.

When you clean the wound, make sure you:

  • Wash your hands before you start.
  • Use a clean, soft washcloth.
  • Dampen the washcloth and use antibacterial soap.
  • Clean in a gentle circular motion. Go from one end of the wound to the other.
  • Rinse the washcloth well to remove the soap. Then repeat the cleaning motion to rinse the wound.
  • Gently pat the wound dry with a clean, dry towel or a washcloth.
  • Use a small amount of ointment on the wound as recommended by the child's doctor.
  • Wash your hands when you finish.

When to call the doctor

Call your child's doctor if your child:

  • Has a temperature higher than 101.5 ºF
  • Is vomiting and cannot keep food down
  • Is more fussy or sleepy
  • Seems confused
  • Seems to have a headache
  • Has a head injury

Also call if the surgery wound:

  • Has pus, blood, or any other drainage coming from it
  • Is red, swollen, warm, or more painful

References

Baskin JZ, Tatum III, SA. Craniofacial surgery for congenital and acquired deforminities. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 185.

Pattisapu JV, Gegg CA, Olavarria G, et al. Craniosynostosis: diagnosis and surgical management. Atlas Oral Maxillofac Surg Clin North Am. 2010;18(2):77-91.

Update Date: 5/15/2014

Updated by: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles CA; Department of Surgery at Ashland Community Hospital, Ashland OR; Department of Surgery at Cheyenne Regional Medical Center, Cheyenne WY; Department of Anatomy at UCSF, San Francisco CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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