Care after thyroid surgery includes early wound surveillance, calcium assessment after total thyroidectomy, hormone replacement and outpatient review.
Immediate care and calcium surveillance
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After surgery, the patient should return to the recovery room and then be nursed overnight on the ward.
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Wound surveillance should include vigilance for a haematoma.
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Calcium levels should be checked after total thyroidectomy. Hypocalcaemia may not develop immediately, so patients should be taught to recognise paraesthesia of the fingers, toes or around the mouth.
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Serial calcium monitoring should be recommended for patients at highest risk.
Replacement therapy and clinic review
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Thyroxine replacement is required after total thyroidectomy and should start on postoperative day 1.
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Clinic review should include checking the histology report, inspecting the wound and examining the larynx for vocal cord function.
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Biochemical assessment of thyroid function, and calcium when required, should be arranged.