What are the treatments for postoperative edema?

From the Guidelines

Postoperative swelling can be effectively managed using non-steroidal anti-inflammatory medication, such as ibuprofen 600 mg TID, and analgesics, such as acetaminophen/paracetamol 500 mg TID, to control postoperative swelling and discomfort over the first 3–7 days after surgery, as recommended by 1.

Management of Postoperative Swelling

To manage postoperative swelling, it is essential to follow general postoperative guidelines, including keeping the surgical area undisturbed, maintaining a well-balanced diet, and staying hydrated, while avoiding the intake of hot foods and beverages.

• Additional specific instructions for patients undergoing maxillary sinus floor augmentation include avoiding strenuous physical activity, not using a straw to drink, and trying to avoid sudden pressure changes.
• Non-steroidal anti-inflammatory medication, such as ibuprofen 600 mg TID, or analgesics, such as acetaminophen/paracetamol 500 mg TID, can be prescribed to control postoperative swelling and discomfort over the first 3–7 days after surgery, as recommended by 1.
• The prescription of opioids is usually not necessary to control postoperative pain and discomfort and must be reserved for specific situations in which the first line of therapy is not effective.
• If there is no medical contraindication, prescription of corticosteroids in decreasing daily doses may also be considered to reduce postoperative edema and other sequelae, such as trismus, as suggested by 1.

Monitoring and Follow-up

Subjects should return between 10 and 14 days after the surgical intervention for suture removal, careful plaque and debris removal, and reinforcement of postoperative instructions.

• It is crucial to monitor patients for potential complications, such as infection, and to seek medical attention if symptoms persist or worsen.
• The occurrence and management of intra- and postoperative complications, such as perforation of the Schneiderian membrane, abnormal postoperative bleeding, and postoperative infections, should be carefully considered, as discussed in 1.

From the FDA Drug Label

Naproxen has been studied in patients with mild to moderate pain secondary to postoperative, orthopedic, postpartumepisiotomy and uterine contraction pain and dysmenorrhea. Onset of pain relief can begin within 1 hour in patients taking naproxen and within 30 minutes in patients taking naproxen sodium Analgesic effect was shown by such measures as reduction of pain intensity scores, increase in pain relief scores, decrease in numbers of patients requiring additional analgesic medication, and delay in time to remedication. The analgesic effect has been found to last for up to 12 hours

Treatment for postoperative swelling may include naproxen, as it has been shown to be effective in reducing pain and inflammation in postoperative patients 2.

• Key benefits of using naproxen for postoperative swelling include:
  • Reduction of pain intensity scores
  • Increase in pain relief scores
  • Decrease in numbers of patients requiring additional analgesic medication
  • Delay in time to remedication
• Duration of action: The analgesic effect of naproxen has been found to last for up to 12 hours.

From the Research

Treatment Options for Postoperative Swelling

• Various studies have investigated the effectiveness of different treatments for postoperative swelling, including negative pressure treatment, compression stockings, and medication.

Negative Pressure Treatment

• A study published in 2020 3 found that a negative pressure treatment using LymphaTouch® can reduce postoperative swelling of the upper arm, wrist, and hand on the first 5 days after surgery.
• The study analyzed 45 patients and found a significant reduction in swelling, with the greatest reduction obtained in the metacarpus and wrist.

Compression Stockings

• A 2019 study 4 found that compression stockings can reduce post-operative limb swelling after arthroscopy, with significant differences in circumference and volume measurements between the compression and no compression groups.
• Another study published in 2011 5 compared compression stockings with bandages after varicose vein surgery and found that patients wearing stockings had less edema and better patient acceptance and quality of life.
• However, a 2013 study 6 found no significant difference in knee swelling and pain after total knee arthroplasty between patients using compression stockings and those not using them.

Medication

• A 1984 study 7 compared naproxen suppositories with oxyphenbutazone suppositories and placebo in postoperative pain and swelling after joint surgery, and found no statistically significant difference between groups for most parameters, although the tendency seemed to favor naproxen.

Comparison of Treatments

• The studies suggest that negative pressure treatment and compression stockings may be effective in reducing postoperative swelling, while the evidence for medication is less clear.
• Further research is needed to determine the most effective treatment for postoperative swelling and to compare the efficacy of different treatments.