Why It Is Important to Cough After Surgery

Coughing is vital to preventing pneumonia

Coughing probably doesn't seem like a big deal in your day-to-day life. You feel the urge to cough, and then you cough. You may not even think about it because it's second nature.

That may change after having surgery. Coughing is not nearly as easy when you are recovering after a procedure, and it certainly isn't painless, either.

Purpose

After surgery, coughing is essential for preventing pneumonia and keeping the lungs clear. Many patients avoid coughing because it can be very painful; however, it is imperative that you cough enough to prevent lung complications. Pneumonia can be a life-threatening problem after surgery and should be avoided at all costs. 

You may not have thought about coughing before, but it does fulfill a necessary objective in the human body: it keeps the lungs clear of normal secretions, infectious material like pus, foreign objects and can help keep the lungs open and well-expanded. 

Coughing after surgery helps prevent pneumonia by encouraging deep breathing. It keeps the lungs expanded and clears any secretion that may have accumulated as a result of mechanical ventilation, intubation, or anesthesia. 

For patients who avoid coughing, or are too weak to cough, it may be necessary to provide assistance in keeping the lungs clear. In the hospital, suction can be used to assist patients with keeping their lungs clear; however, coughing is much more effective and preferable to suction.

How to Cough After Surgery

When you feel the urge to cough, you should brace your incision if you have had a chest or abdominal surgery. That means taking your hands or a small pillow and hugging it to your incision when you cough, applying gentle but firm pressure. This bracing action will help support your incision and reduce the stress on the site.

If the incision is on your chest, such as after open heart surgery, hug a pillow to your chest directly over the incision. If you had abdominal surgery, you would do the same over the abdominal incision while slightly tensing the stomach muscles.

If no pillow is available, you can use your hands to brace the incision, as the pillow is primarily used for comfort.

Even if your incision is not on your chest or abdomen, bracing may help with pain control. Crossing the legs can also provide bracing if your surgery was in the genital or rectal areas.

Preventing Dehiscence

Bracing your incision is very important for several reasons. Holding pressure on your incision while you cough decreases the stress on it, which can significantly decrease the pain you feel. In addition, the support you give your incision can prevent it from pulling apart and opening, a complication called dehiscence, which can become very serious.

During your routine incision care, be sure to inspect your incision for any signs that it is pulling apart or gaps are forming. Detecting small openings in an incision is not always an issue, but these openings can lead to larger openings if the incision continues to be under significant stress. 

For example, a person who caught a cold and was coughing and sneezing frequently would put more stress on their abdominal incision than what is typical. This patient would be at risk for their incision opening and should take care to support the incision when they cough.

The same idea applies to sneezing. Bracing will help protect your incision and help minimize the pain.

Never stifle a sneeze. Doing so may cause the rupture of blood vessels in the throat, damage the eardrum and inner ear, or even trigger an aneurysm. Simply brace the incision, tighten the abdominal muscles, and sneeze.

Coughing and Deep Breathing Exercises

Coughing and deep breathing (CDB) is a technique used to help keep the lungs clear during the first few days or weeks after surgery. Repeated several times per day, the cough and deep breathing exercises are a very effective tool to prevent pneumonia and atelectasis, a lung condition where the lungs don't expand the way they should.

The technique varies slightly between facilities and physicians, but the general idea is the same. To perform a CDB exercise:

  1. Take a deep breath, hold for several seconds, and slowly exhale.
  2. Repeat five times.
  3. Brace your incision, and attempt to cough deeply.
  4. Repeat the entire procedure every one to two hours.

A Word From Verywell

Coughing properly may seem to simple to be truly effective in the prevention of serious complications after surgery, but it can prevent major issues from happening in the days and weeks following surgery. 

A failure to cough, most often due to pain, can lead to pneumonia very quickly. Coughing improperly, without bracing the incision, can lead to the opening of an incision or even more serious conditions. 

If you are caught off-guard and a cough or sneeze causes a rupture in your incision or sutures, seek medical help.

When to Call a Doctor

  • If you notice an opening in your incision, even a small one
  • If you notice blood after coughing
  • If coughing causes severe pain
  • If you cannot brace an incision because it is is too painful
  • If you feel too weak to cough or are not strong enough to cough effectively
  • If you have difficulty breathing or cannot catch your breath
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