Vertical Expandable Prosthetic Titanium Rib (VEPTR) Surgery Home Care

We placed titanium implants in your child’s rib cage to help better position his or her chest, back and/ or spine and pelvis. The general information in this handout will help when you return home after a Vertical Expandable Prosthetic Titanium Rib (VEPTR) surgery. Your health care provider might give you additional instructions. 

Ask your health care provider about specific activities that your child would like to start doing again. Gradually increase the level of activity. 

A balanced diet is important after VEPTR surgery to maintain muscle tone and bone strength. Consuming enough protein is important to the healing process. A dietician can help you figure out how much protein your child is eating and drinking. Foods high in protein include seafood, chicken, milk, cheese, yogurt, beans, beef and soy. 

Also, increase the amount of fiber and fluids in your child’s diet to help prevent constipation. 

Your child needs to exercise his or her lungs after surgery to prevent fevers and help the healing process. Your respiratory therapist will teach your child how to use an incentive spirometer, a device that helps you take big breaths. Your child can also exercise his or her lungs by blowing bubbles, playing a harmonica or recorder, blowing a pinwheel, or doing other similar activities. Lung exercises should be done every 1 to 2 hours each day. 

Some people recovering from VEPTR surgery have a difficult time sleeping seven to eight hours. Sleeping in a reclining chair or using extra pillows in bed might help your child sleep more comfortably. 

On long car trips remember to stop and have your child move around every one to two hours. Walking for about 10 minutes will help prevent stiffness. Always use a seat belt. 

Your child will usually be able to return to school one to two weeks after leaving the hospital. You might consider having your child go back gradually. Do half days at first, and then increase to full days.

Before your child leaves the hospital, ask your health care provider for a note that will excuse your child from gym class. You also could get written permission that allows your child to leave a class early so he or she can get to the next one more easily.

We strongly recommend that your child showers rather than takes a bath until the incision has healed. Here are some tips that might make showering easier:

• Make sure the shower stall or tub is dry. 
• Use a bath chair until your child is stronger. 
• Use a hand-held shower, if possible. 
• Help your child until he or she is comfortable and stronger. 
• Make sure the bathroom floor isn’t slippery. 

Once the incision has completely healed, around two weeks after surgery, you could try giv¬ing your child a bath. To make sure your child can get in and out of the tub, have him or her practice getting up from the floor. Remind your child to bend his or her knees and keep his or her back straight. 

Check the incision every day for signs of infection. Some numbness around the incision is normal. Call your health care provider or Telehealth Nursing (651-229-3890) if you notice any of the following: 

• Heat or warmth around the incision 
• Redness, swelling or drainage 
• Persistent fever higher than 100.5 degrees 
• Numbness, tingling or weakness in your arms or legs 
• Pain (refer to the Pain Management at Home Following Surgery patient education handout) 

The bandages on the incision should come off on their own, but you can remove them if they become dirty or are still on after two weeks. 

To prevent the incision from darkening, your child should avoid direct sunlight for up to a year after surgery. If your child can’t avoid direct sunlight, have him or her wear white clothing to reflect light and use sunscreen. 

Call Telehealth Nursing (651-229-3890) if:

• The implants seem to have changed position. (VEPTRs can shift or break through ribs.) 
• You’re not able to manage your child’s pain. 
• Your child has changes in circulation, motion, or sensation in his or her arms or legs.