Why It Is Important to Cough Correctly After Surgery

How To Cough the Right Way After Having Surgery

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.

Why Is Coughing Important After Surgery?

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 works to prevent pneumonia by encouraging both deep breathing to keep the lungs expanded and by clearing secretions from the lungs. 

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: Bracing Your Incision

When you feel the urge to cough, you should brace your incision if you have a chest or abdominal surgical site. 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 your incision is on your chest, such as after an open heart surgery, you would hug a pillow to your chest directly over your incision. If your incision is on your abdomen, you would hug a pillow to your abdominal incision.

If no pillow is available, you can use your hands to brace the incision, as the pillow is primarily 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. In general, the idea is to support the incision with your hand or a pillow, to reduce the pain of coughing as well as the provide support to the incision--an area that is far weaker than normal during the early stages of healing.

Why You Should Brace Your Incision When Coughing

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 or sneeze.

How To Do Cough and Deep Breathe Exercises

Coughing and deep breathing 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.

  1. Take a deep breath, hold it for several seconds, and then slowly let it out.
  2. Repeat step one five times.
  3. Brace your incision and attempt to cough deeply.
  4. Repeat every 1-2 hours.

Sneezing After Surgery

The idea is the same with sneezing as it is with coughing -- bracing will protect your incision and help minimize the pain you feel. Never stifle a sneeze; holding one in can be far more painful than just letting it happen naturally.  

When You Should Call Your Doctor

You should call your surgeon if you experience any of the following issues:

  • You notice an opening in your incision, even if it is a small one.
  • You notice any blood when you cough.
  • You feel too weak to cough or are not strong enough to cough effectively.
  • If you have difficulty breathing, or cannot catch your breath, seek immediate medical attention.

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. 

Coughing properly is easy to do, takes little time and can prevent issues that will make the recovery period last days, weeks or even months longer than it should. 

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