Lesson 1Follow-up plannin', reassessment fi definitive elective surgery if indicated, an' documentation fi outpatient handoverDis section explains how to plan follow-up after ulcer surgery, reassess di need fi definitive elective procedures, an' create clear documentation an' discharge summaries dat support safe outpatient continuity a care.
Schedulin' early an' long-term surgical follow-upCriteria fi considerin' definitive elective surgeryKey elements a a safe discharge summaryCommunication wid primary care an' gastroenterologyPatient education fi warnin' signs after dischargeLesson 2Nutrition an' mobilization: NPO duration, nasogastric tube indications, timin' a enteral feedin'Dis section addresses postoperative nutrition an' mobilization, includin' NPO duration, nasogastric tube indications, timin' an' route a enteral feedin', an' protocols dat promote early ambulation an' enhanced recovery.
Criteria to discontinue nasogastric decompressionAssessin' readiness to start oral intakeStepwise advancement a postoperative dietEnteral versus parenteral nutrition decisionsEarly mobilization an' physiotherapy protocolsLesson 3Recognition an' management a late complications: fistula, adhesive obstruction, recurrent ulcerationDis section reviews late postoperative complications after ulcer surgery, includin' fistula, adhesive obstruction, an' recurrent ulceration, focusin' on clinical recognition, diagnostic workup, an' stepwise medical, endoscopic, or surgical management.
Clinical features a postoperative enterocutaneous fistulaEvaluation an' imaging a adhesive small bowel obstructionManagement a chronic fistula output an' nutritionDiagnosis a recurrent ulceration after surgeryEndoscopic an' surgical options fi recurrent ulcersLesson 4Analgesia plans includin' multimodal strategies an' opioid-sparin' optionsDis section presents multimodal postoperative analgesia strategies, emphasizin' regional techniques, non-opioid adjuncts, opioid-sparin' regimens, monitorin' fi side effects, an' tailorin' pain control to enhance recovery an' mobilization.
Pain assessment scales an' documentationUse a acetaminophen an' NSAIDs safelyRegional blocks an' epidural analgesia optionsAdjuvant agents such as gabapentinoidsDesignin' opioid-sparin' analgesia protocolsLesson 5Immediate postoperative monitorin' in PACU/ICU: parameters, frequency, an' escalation triggersDis section outlines structured monitorin' in PACU an' ICU after ulcer surgery, definin' vital parameters, pain an' sedation assessment, monitorin' frequency, an' clear triggers fi escalation, rapid response activation, or transfer to higher care.
Standard PACU monitorin' set an' documentationHemodynamic an' urine output targets after surgeryRespiratory monitorin' an' pulse oximetry strategyPain, sedation, an' delirium assessment toolsEscalation triggers an' rapid response activationLesson 6Early postoperative investigations: labs, radiographs, CT indications fi suspected leak or abscessDis section explains when an' how to use labs, radiographs, an' CT after ulcer surgery to detect leaks or abscesses early, interpret key findin's, an' choose appropriate escalation, drainage, or reoperation strategies.
Baseline an' serial postoperative laboratory panelsUse a plain radiographs an' contrast swallow studiesCT indications fi suspected leak or abscessImaging signs a anastomotic leak an' collectionsAlgorithm fi escalatin' from labs to advanced imagingLesson 7Infection prevention an' antibiotic stewardship: duration, de-escalation based on culturesDis section reviews infection prevention an' antibiotic stewardship after ulcer surgery, coverin' perioperative prophylaxis duration, culture-guided de-escalation, monitorin' fi failure, an' strategies to limit resistance an' C. difficile.
Appropriate duration a surgical prophylaxisEmpiric therapy fi suspected intra-abdominal sepsisCulture collection an' interpretation principlesAntibiotic de-escalation an' stop criteriaMonitorin' fi C. difficile an' resistant organismsLesson 8Thromboprophylaxis, glycemic control, an' wound care best practicesDis section details best practices fi thromboprophylaxis, glycemic control, an' wound care after ulcer surgery, includin' risk stratification, pharmacologic an' mechanical measures, glucose targets, an' strategies to prevent wound infection.
VTE risk assessment an' prophylaxis selectionTimin' an' dosin' a pharmacologic anticoagulationMechanical prophylaxis an' mobilization protocolsPerioperative glycemic targets an' insulin regimensWound dressin' choices an' infection preventionLesson 9Recognition an' management a early complications: leak, intra-abdominal abscess, sepsis, respiratory complicationsDis section covers recognition an' management a early complications such as anastomotic leak, intra-abdominal abscess, sepsis, an' respiratory events, emphasizin' early warnin' signs, diagnostic pathways, resuscitation, an' timely source control.
Clinical red flags fi anastomotic leakSepsis bundles an' hemodynamic resuscitationDiagnosis an' drainage a intra-abdominal abscessPrevention an' treatment a postoperative pneumoniaCriteria fi reoperation versus percutaneous drainageLesson 10Long-term medical management a peptic ulcer disease: H. pylori testin' an' eradication, PPI therapy, NSAID avoidance, smokin' an' alcohol counselin'Dis section focuses on long-term medical management a peptic ulcer disease, includin' H. pylori testin' an' eradication, PPI strategies, NSAID risk mitigation, an' counselin' on smokin', alcohol, an' adherence to therapy.
Indications an' methods fi H. pylori testin'Standard an' rescue H. pylori eradication regimensOptimizin' PPI dosin' an' taperin' strategiesManagin' NSAID an' antiplatelet exposureLifestyle counselin' on smokin' an' alcohol
