What post-procedure instructions and follow-up care should be provided to a patient who had an InterStim (interstitial stimulator) device placed 1 week ago?

Post-Procedure Instructions for InterStim Patients at One-Week Follow-up

At the one-week follow-up after InterStim placement, patients should be instructed to monitor the implant site daily for signs of infection, keep the site clean and dry, and begin device mobilization if the incision has healed properly. 1, 2

Wound Care Instructions

Site Monitoring and Cleaning

• Assess the incision site for proper healing and signs of infection (redness, swelling, drainage, pain, warmth)
• If the incision has healed properly (typically by 5-7 days):
  • Clean the site twice weekly with mild soap and water 1
  • Gently dry the area thoroughly after cleaning
  • No need for daily dressing changes once healed 1
• If the incision is not fully healed:
  • Continue daily monitoring and aseptic wound care 1
  • Keep the site clean and dry
  • Consider glycerin hydrogel dressing as an alternative to standard dressings 1

Bathing/Swimming Guidelines

• Once the incision is well-healed:
  • Showering is permitted (typically after 1-2 weeks)
  • Avoid baths, hot tubs, or swimming for at least 2-3 more weeks 1
  • When swimming is eventually permitted, cover the site with a waterproof dressing in public pools 1

Device Management

Device Mobilization

• If the incision has healed properly (typically by one week):
  • Begin gentle device mobilization to prevent adherence to surrounding tissue 1
  • Teach patient how to gently move the device within the pocket to prevent complications
  • Avoid excessive manipulation that could cause discomfort or damage

Activity Restrictions

• Avoid strenuous activities or movements that place tension on the implant site for 4-6 weeks
• Avoid excessive bending, twisting, or stretching that could displace the device
• Gradually return to normal activities as comfort allows

Warning Signs to Report Immediately

Instruct patients to contact their healthcare provider immediately if they experience:

• Fever or chills
• Increasing pain, redness, swelling, or warmth at the implant site
• Drainage or discharge from the incision
• Device migration or erosion through the skin
• Unusual sensations or changes in stimulation patterns
• Any new neurological symptoms

Follow-up Care

• Schedule next follow-up appointment (typically 4-6 weeks after implantation)
• Provide written instructions for device programming and troubleshooting
• Ensure patient has emergency contact information for device-related concerns

Special Considerations

MRI Compatibility

• Inform patients about MRI compatibility issues with their specific InterStim model
• For patients with InterStim Twin models, MRIs should generally be avoided, though limited evidence suggests some patients have undergone MRI without complications 3

Antibiotic Prophylaxis

• Routine postoperative antibiotic therapy is not recommended due to risk of adverse events and development of resistant organisms 1
• Patients should understand that antibiotic prophylaxis for routine dental or other procedures is not necessary 1

Patient Education on Expected Outcomes

• Explain that full therapeutic benefit may take several weeks to develop 4
• Review expected improvements in symptoms based on their specific condition (urinary or fecal incontinence, retention, etc.)
• Discuss the importance of keeping a symptom diary to track progress and facilitate programming adjustments

By following these instructions, patients can minimize the risk of complications and optimize their outcomes with InterStim therapy. Thorough patient education is essential for early identification of potential complications and successful management of the device.