Aralin 1Follow-up planning, reassessment para sa definitive elective surgery kung indicated, at dokumentasyon para sa outpatient handoverAng seksyong ito ay nagpapaliwanag kung paano magplano ng follow-up pagkatapos ng ulcer surgery, magreassess ng pangangailangan para sa definitive elective procedures, at lumikha ng malinaw na dokumentasyon at discharge summaries na sumusuporta sa ligtas na outpatient continuity of care.
Pag-schedule ng maagang at long-term surgical follow-upCriteria para sa pag-isaalang-alang ng definitive elective surgeryKey elements ng ligtas na discharge summaryKomunikasyon sa primary care at gastroenterologyPatient education para sa warning signs pagkatapos ng dischargeAralin 2Nutrition at mobilization: NPO duration, nasogastric tube indications, timing ng enteral feedingAng seksyong ito ay tumutugon sa postoperative nutrition at mobilization, kabilang ang NPO duration, nasogastric tube indications, timing at route ng enteral feeding, at protocols na nagpo-promote ng maagang ambulation at enhanced recovery.
Criteria upang itigil ang nasogastric decompressionPagsusuri sa readiness upang magsimula ng oral intakeStepwise advancement ng postoperative dietEnteral versus parenteral nutrition decisionsMaagang mobilization at physiotherapy protocolsAralin 3Pagkilala at management ng late complications: fistula, adhesive obstruction, recurrent ulcerationAng seksyong ito ay nagre-review ng late postoperative complications pagkatapos ng ulcer surgery, kabilang ang fistula, adhesive obstruction, at recurrent ulceration, na nakatuon sa clinical recognition, diagnostic workup, at stepwise medical, endoscopic, o surgical management.
Clinical features ng postoperative enterocutaneous fistulaEvaluation at imaging ng adhesive small bowel obstructionManagement ng chronic fistula output at nutritionDiagnosis ng recurrent ulceration pagkatapos ng surgeryEndoscopic at surgical options para sa recurrent ulcersAralin 4Analgesia plans na kabilang ang multimodal strategies at opioid-sparing optionsAng seksyong ito ay nagpapakita ng multimodal postoperative analgesia strategies, na binibigyang-diin ang regional techniques, non-opioid adjuncts, opioid-sparing regimens, monitoring para sa side effects, at pag-tailor ng pain control upang mapahusay ang recovery at mobilization.
Pain assessment scales at dokumentasyonLigtas na paggamit ng acetaminophen at NSAIDsRegional blocks at epidural analgesia optionsAdjuvant agents tulad ng gabapentinoidsPagdidisenyo ng opioid-sparing analgesia protocolsAralin 5Immediate postoperative monitoring sa PACU/ICU: parameters, frequency, at escalation triggersAng seksyong ito ay nag-o-outline ng maestrukturadong monitoring sa PACU at ICU pagkatapos ng ulcer surgery, na nagdedepina ng vital parameters, pain at sedation assessment, monitoring frequency, at malinaw na triggers para sa escalation, rapid response activation, o transfer sa higher care.
Standard PACU monitoring set at dokumentasyonHemodynamic at urine output targets pagkatapos ng surgeryRespiratory monitoring at pulse oximetry strategyPain, sedation, at delirium assessment toolsEscalation triggers at rapid response activationAralin 6Maagang postoperative investigations: labs, radiographs, CT indications para sa suspected leak o abscessAng seksyong ito ay nagpapaliwanag kung kailan at paano gumamit ng labs, radiographs, at CT pagkatapos ng ulcer surgery upang makita ang leaks o abscesses nang maaga, mag-interpret ng key findings, at pumili ng appropriate escalation, drainage, o reoperation strategies.
Baseline at serial postoperative laboratory panelsPaggamit ng plain radiographs at contrast swallow studiesCT indications para sa suspected leak o abscessImaging signs ng anastomotic leak at collectionsAlgorithm para sa pag-escalate mula labs hanggang advanced imagingAralin 7Infection prevention at antibiotic stewardship: duration, de-escalation batay sa culturesAng seksyong ito ay nagre-review ng infection prevention at antibiotic stewardship pagkatapos ng ulcer surgery, na tumutukoy sa perioperative prophylaxis duration, culture-guided de-escalation, monitoring para sa failure, at strategies upang limitahan ang resistance at C. difficile.
Appropriate duration ng surgical prophylaxisEmpiric therapy para sa suspected intra-abdominal sepsisCulture collection at interpretation principlesAntibiotic de-escalation at stop criteriaMonitoring para sa C. difficile at resistant organismsAralin 8Thromboprophylaxis, glycemic control, at wound care best practicesAng seksyong ito ay nagdedetalye ng best practices para sa thromboprophylaxis, glycemic control, at wound care pagkatapos ng ulcer surgery, kabilang ang risk stratification, pharmacologic at mechanical measures, glucose targets, at strategies upang maiwasan ang wound infection.
VTE risk assessment at prophylaxis selectionTiming at dosing ng pharmacologic anticoagulationMechanical prophylaxis at mobilization protocolsPerioperative glycemic targets at insulin regimensWound dressing choices at infection preventionAralin 9Pagkilala at management ng early complications: leak, intra-abdominal abscess, sepsis, respiratory complicationsAng seksyong ito ay tumutukoy sa pagkilala at management ng early complications tulad ng anastomotic leak, intra-abdominal abscess, sepsis, at respiratory events, na binibigyang-diin ang early warning signs, diagnostic pathways, resuscitation, at timely source control.
Clinical red flags para sa anastomotic leakSepsis bundles at hemodynamic resuscitationDiagnosis at drainage ng intra-abdominal abscessPag-iwas at treatment ng postoperative pneumoniaCriteria para sa reoperation versus percutaneous drainageAralin 10Long-term medical management ng peptic ulcer disease: H. pylori testing at eradication, PPI therapy, NSAID avoidance, smoking at alcohol counselingAng seksyong ito ay nakatuon sa long-term medical management ng peptic ulcer disease, kabilang ang H. pylori testing at eradication, PPI strategies, NSAID risk mitigation, at counseling sa smoking, alcohol, at adherence sa therapy.
Indications at methods para sa H. pylori testingStandard at rescue H. pylori eradication regimensPag-optimize ng PPI dosing at tapering strategiesPag-manage ng NSAID at antiplatelet exposureLifestyle counseling sa smoking at alcohol
