The physiological stress applied to the body during surgery can cause great complications. The patient is in a decreased physical state andthis poses risk and harm to the tissues of the body and the organ systems. Great research has been emphasized on the effects of the body after prolonged immobilization. The systems as greatest risk are the integumentary system(skin), the pulmonary system(lungs), the GI system (small/large bowel), and the muscular-skeletal system. In earlier years of surgery it was expected that the patient would stay in beds for days and weeks following surgery. This was seen as beneficial as the patient had to rest. Through patient complications and research this is now known to do harm to the patient.
As a person lies in bed and does not exert themselves they tend to not breathe deeply. After surgery, whether or not the patient had general anesthesia and required mechanical ventilation, the lungs are at risk for complication. One of the greatest complications is atalectasis. This is when the tiny air sacs of the lung collapse due to lack of deep breathing and keeping them filled with air. This can lead to low oxygenation and potential for pneumonia. Getting up out of bed encourages deep breathing and benefits the lungs and helped prevent this complication from occurring.
If the body is not active, the circulatory system can be affected. As a person lies in bed and does not move, the risk for developing blood clots rises. A known complication from most surgical procedures is known as a DVT, or deep vein thrombosis. This happens as blood pools in the vein from lack of return to the heart. The way this blood is circulated from the veins to the heart is by aid of the muscles. A common place for this complication to occur is in the lower legs. For this reason, getting out of bed after surgery helps reduce this risk by using the muscles in the legs by walking to keep the circulation going.
Our skin and tissue reacts to pressure. If pressure is applied to it for a long period of time, the lack of circulating blood can cause it to die. Lying in bed for a long period of time places certain areas of the skin at risk for this to happen. A common place is on the bony areas of the back and tailbone, heels, elbows, and the back of the head. Lying in bed increases the risk on pressure related ulcers and sores. Getting out of bed ensures adequate blood flow and reduction of pressure to these areas.
These are big reasons to mobilize a post-surgical patient from bed. The risk of complication is reduced the sooner the patient is mobilized. The longer the patient stays in bed, the greatest the risk. Many theories of when to get a patient out of bed after surgery range from the immediate hours to the next day. All in all, the research shows the sooner the better, and as long as the patient can tolerate getting up, the risk should be reduced by doing as soon as possible.
