Complications After Receiving a Device, Implant, or Graft
ContentsCommon Devices, Implants, And Grafts Learning About A Device, Implant, Or Graft Complications What To Expect After The Procedure Complications After The Procedure Preventing Complications The Caregiver’s Role The Roles Of Various Healthcare Providers Determining What Level Of Care Is Needed Care Needs After Receiving A Device, Implant, Or Graft Selecting A Professional Caregiver Paying For At-Home Care Making The Home Safe When Additional Care Is Needed Residential Long-Term Care Options Selecting A Long-Term Care Facility Paying For Long-Term Care Financial And Legal Considerations Planning For Future Care Needs FAQs About Complications After Receiving A Device, Implant, Or Graft
A medical implant is a device, tissue, or synthetic piece of material that a doctor inserts into the body or applies to the skin. The use of these types of materials are increasingly common in modern medicine and understanding how they may affect a family member or person is important. After reading this guide, you will be more familiar with common complications associated with medical devices, implants, and grafts and why they may be needed.
Unlike transplants, these devices or tissues are man-made. Devices and implants may serve any of the following purposes for patients including:
- Replace damaged tissue or body parts (such as teeth, bone)
- Support or improve organ function
- Administer medications
- Monitor bodily functions and/or detect problems
Common Devices, Implants, And Grafts
Due to advances in medical research and technology, the variety of medical devices, implants, and grafts as well as the types of graft material that may be used for these procedures has grown exponentially over the last decade.
Along with these developments have also come advances in transplant, grafting, and implantation techniques.
A graft involves taking tissue from one part of the body and moving it to another location on the body. The most common type of graft is a skin graft. This procedure is usually performed when the skin or tissue has been damaged due to an injury, burn, or surgical procedure.
Grafts such as Dacron grafts are designed to repair damaged blood vessels and are often made out of man-made materials rather than tissue from one’s own body.
Nevertheless, the most common types of grafts and implants fall into the following categories:
- Blood vessel grafts - Grafting damaged or weak blood vessels such as the aorta as a result of an aneurysm is accomplished with grafts such as a stent graft or patch graft. Other types of grafts such as the HeRO graft provide blood vessel access for hemodialysis patients when previous fistulas and grafts have failed.
- Bone grafts for bone loss - Bone grafting using a patient’s own bone (called an autogenous bone graft) is increasingly common with dental implants. A bone graft may also be done for hips, knees, or the spine due to bone deterioration from osteoarthritis or cancer.
- Dental implants - These implants most commonly replace roots for teeth and may require bone grafting before implantation.
- Ear implants and bone-anchored hearing aids to restore hearing
- Eye implants and glaucoma drainage devices - These include glaucoma drainage implants such as the baerveldt implant and molteno implant which relieve pressure in the eye due to a buildup of fluid.
- Joint implants or replacements - A variety of devices are used for restoring function and range of motion to damaged joints through surgeries such as a knee replacement or total hip replacement. A meniscus implant may also be used to replace worn out cartilage in a knee.
- Heart implants - Pacemakers are a well-known type of implant for the heart. However, patients who have a weak left ventricle in their heart may also have a ventricular assist device implanted known as a left ventricular assist device (LVAD) which helps the heart pump blood throughout the body.
- Port implantation - Some patients also have ports implanted into different areas of their body which allow medications to be administered quickly and effectively.
Learning About A Device, Implant, Or Graft Complications
It is important that family members and caregivers familiarize themselves with the type of implant or device the individual has received. Additional equipment or external devices may also be issued along with the implant. Caregivers should learn how to operate this equipment safely. It may be helpful for caregivers to use a checklist to ensure that all equipment and devices are used correctly and safely.
If an individual has had a port implanted, they or their caregivers may be responsible for administering certain medications through the port or intravenous (IV). Even if the individual is able to self-administer medications, caregivers should understand this process in case the person requires assistance.
Many individuals receive a card or informational sheet to carry in their wallet or purse. These cards will inform medical personnel about the exact type of implant or device used by the individual. Caregivers and family members should know where this information is kept so they are prepared to provide this information to paramedics in the event of an emergency.
What To Expect After The Procedure
After receiving an implant or graft, an individual will often experience pain, redness, swelling, or sensitivity around the site of the implant/graft. Recovery time will depend on which procedure was performed and whether the individual has any other health conditions or complex healthcare needs.
In some cases, an implant or medical device may be inserted during a simple outpatient procedure. However, if an individual has extensive health problems or requires major surgery, they may need to be hospitalized for some time and kept under close medical supervision.
Complications may sometimes arise even if the procedure was considered “low-risk”. Individuals and caregivers must be vigilant about monitoring the person’s health following any procedure.
Complications After The Procedure
The most common complication is an infection at the surgical site. With certain procedures, there may also be a risk that the individual’s immune system will attack or reject the implant or graft.
Symptoms of a surgical site infection may include:
- Redness around the incision site
- Swelling around the incision site
- Pus draining from the incision
If the individual develops symptoms of an infection following the procedure, they should contact their doctor right away.
In the event that an individual experiences severe chest pain, has difficulty breathing, or unexpectedly loses consciousness, call 9-1-1 or go to the nearest emergency room.
Other potential complications may include:
- Excessive bleeding from the site of the implant/graft
- Pain or irritation around implant/graft
- Blood clots
- Nerve damage
In rare cases, an implant may move, break, or malfunction. If this happens, the doctor may need to remove or replace the implant. The doctor will provide guidance on how to determine whether the implant is working properly and what to do if a problem is suspected.
Caregivers can help an individual avoid complications by encouraging them to carefully follow the doctor’s instructions. Family members should also know the symptoms of infection or other potentially life-threatening emergencies so they are able to call for help if necessary.
After the procedure, an individual may be required to change the dressing around the incision site or cleanse the affected area. The hospital discharge instructions regarding this process should be carefully followed. Failing to follow these instructions may increase one’s risk of developing an infection.
Family members and caregivers can help prevent infection by washing their hands frequently and ensuring that the individual cares for the surgical incision in a hygienic manner. If the individual or caregiver has been instructed to cleanse the area, they should carefully wash their hands before and after performing this task even if gloves are used.
The Caregiver’s Role
The level of care an individual requires will depend on what type of implant or graft they received and their overall prognosis.
Some individuals only require short-term care while they recover from the initial procedure. A person may be able to care for themselves after only a few days. Other individuals may require care for many months or for the rest of their lives.
An individual’s doctor will provide more details about their prognosis and what level of care they will require for the foreseeable future.
The Roles Of Various Healthcare Providers
The type of medical provider needed will vary depending on the type of device, implant, or graft procedure. Many individuals receive an initial diagnosis from their primary care doctor. Depending on one’s medical needs, they may then be referred to a specialist.
Individuals who require a device, implant, or graft will typically receive care from a doctor who specializes in injuries or diseases affecting a specific body system or part. A device, implant, or graft procedure is often performed by a surgeon who specializes in the recommended procedure.
Individuals who need a stent or pacemaker will likely be referred to a cardiologist or vascular specialist. The implant or device will often be placed by a cardiothoracic surgeon. This type of surgeon specializes in surgeries of the heart and lungs.
Individuals who undergo joint replacement surgery are often cared for by orthopedic doctors. These doctors specialize in health conditions affecting bones, muscles, and joints. Following these types of procedures, individuals usually require physical or occupational therapy as well.
Individuals who receive skin grafts often receive care from a plastic surgeon. In some cases, an individual may also consult with a dermatologist or other skin specialist following their procedure.
An individual’s primary care doctor will typically provide the necessary referrals for specialists and surgeons. Individuals and caregivers may wish to ask prospective care providers some of the following questions:
- How often do you treat individuals with this specific health condition?
- How many times have you performed this procedure?
- What are the risks associated with this procedure?
- How often is this procedure successful in resolving this health condition? How will we be able to determine if the procedure was a success?
- Will this device/implant be permanent or will it be removed or replaced at some point?
- How will this procedure affect the individual’s life? Will they be able to resume normal activity? If so, how long will recovery take?
- What care needs will the individual have while they recover?
Determining What Level Of Care Is Needed
An individual usually requires the most care immediately after a procedure although the nature of procedures vary greatly. A device, implant, or graft may be placed during an outpatient procedure or a person may require hospitalization for the procedure.
If an individual has been allowed to return home after a procedure, they may need at-home care while they recover. The individual and their family should consult the doctor to learn more about what kind of short-term care they will need after the procedure. Depending on the nature of the procedure and the individual’s health, they may require professional assistance from a caregiver with medical training.
In order to determine whether professional care is needed, it is recommended that an individual and their family ask the doctor the following questions:
- Will they be able to be mobile after the procedure? Will they be able to get up from a bed without assistance?
- Is there special equipment which they will need to use at home? Can this equipment be safely used without special training or instruction?
- Once the individual returns home, will it be necessary to monitor their vital signs such as their blood pressure or heart rate?
- Will there be any dressings which must be changed or removed? Can the person or their family safely perform this task?
- Will the individual be able to independently perform the activities of daily living (ADLs) such as bathing, grooming, dressing, and using the toilet?
Family members should also consider their own level of availability. If an individual expects that they will need assistance and family will not be available to provide care, a professional caregiver may be required.
Care Needs After Receiving A Device, Implant, Or Graft
Individuals who have received a device, implant, or graft may have a wide variety of care needs. If an individual has undergone a minor procedure and has experienced no complications, they may be able to care for themselves soon after their procedure.
However, individuals who have undergone major surgery or experienced serious complications may need ongoing care from a family member, professional caregiver, home health agency, or long-term care facility.
Depending on the type of device, implant, or graft, an individual may need to delay regular bathing habits for several days or even weeks while the area heals. In some cases, they may need to cover the area with a waterproof dressing or use other methods to keep the area dry while bathing.
An individual should receive hospital discharge or follow-up instructions explaining when they may resume normal bathing activities. If the instructions do not cover this topic, they should ask their doctor when it is safe to cleanse the affected area and what bathing products should be used.
Clothing that is too restrictive around the site of the device, implant, or graft should be avoided. Depending on the doctor’s instructions, the individual may need to avoid covering the affected area with any type of clothing.
During the recovery process, the person may feel most comfortable in clothing made of light, breathable materials such as cotton. They may also have some difficulty moving certain joints or using their full range of motion. Light materials and loose cuts of clothing will allow them to move more easily.
The doctor or discharge nurse will provide instructions on when an individual may resume their normal eating habits. They may need to eat light or easily-digestible meals for the first few hours or days following their procedure. Foods such as broth, applesauce, or yogurt may be recommended.
Unless a doctor directs otherwise, the individual should remain well-hydrated by drinking their daily recommended intake of water and other clear liquids. Seniors are at a particular risk of developing complications due to dehydration. Caregivers can help by providing the person with plenty of water.
After receiving a device, implant, or graft procedure, individuals may need to alter their personal hygiene habits while the affected area heals. The discharge instructions will usually offer guidance on this. If they do not, the doctor should be consulted for more information.
Many people experience swelling, bruising, redness, or other discoloration around the area of the implant or graft. Contact the doctor if these symptoms become more severe over time, do not improve after a few days, or are accompanied by a fever.
The area where the device, implant, or graft was placed will need to be kept clean and dry for several days or weeks following the procedure. However, the person may be permitted to resume other grooming tasks once they return home. Consult the doctor or discharge instructions to learn about any personal care activities or products which should be avoided.
If the person is advised not to lift their arms or to avoid certain movements which may strain the affected area, they may need help with certain grooming tasks such as brushing and styling their hair.
Individuals who have recently had outpatient surgery are often able to use the toilet independently after returning home. However, if they have had a lengthy hospitalization or have undergone a surgery which severely limits their mobility, they may require a caretaker’s help in this area.
Ask the doctor if they anticipate that the individual will be able to safely use the toilet on their own. Falls are potentially dangerous so it is important that individuals do not use the toilet on their own if they feel dizzy or faint.
Transfer From Bed To Chair
Depending on the type of procedure, a person may or may not be able to move about freely after returning home. If the person struggles with mobility, a mobility aid may be helpful. These devices are often available for rental or purchase from a medical device supply store. Ask the doctor if they recommend using such a device.
Individuals who have recently undergone surgery or who are taking prescription pain medication should be supervised carefully after returning home. Some medications administered during or after surgery may cause dizziness or fainting. A caregiver’s assistance may be required.
The doctor or discharge nurse may recommend that the affected area be kept as still as possible to allow the incision site time to heal. The individual may be advised to avoid vigorous exercise, lifting heavy objects, or any activity that may cause damage to the area where the device, implant, or graft was placed.
It is important that these instructions are carefully followed. Failure to do so may result in serious injury or damage to the device/implant/graft.
It is extremely important that an individual take all medications as prescribed. The doctor may prescribe antibiotics or pain medications to be taken during the days following the surgery. If antibiotics are prescribed, it is important that the person take all their medication even if they do not believe that they have any symptoms of an infection.
The person may also be instructed to stop taking certain medications such as blood thinners immediately before or immediately after surgery. Ask the doctor or discharge nurse when the individual may resume taking their medication. The person should not stop taking their medication without consulting their doctor.
The most common symptoms experienced after the procedure is pain around the area where the device, implant, or graft was placed. An individual’s doctor or discharge nurse will provide more instructions about what pain-relief methods are safe and recommended.
The doctor may recommend over-the-counter medications or prescription pain-relief medications. The person should not use over-the-counter medications without a doctor’s recommendation after the procedure. In some cases, ice packs may help ease pain and swelling. However, the use of ice may not be safe for all individuals. Ask the doctor if it is safe to apply ice and which type of ice or cold pack is recommended.
Special Medical Equipment And Supplies
Individuals who have received devices, implants, or grafts may require different kinds of medical equipment. Some individuals may require mobility aids such as wheelchairs, scooters, or walkers.
These items may be acquired directly from the doctor or hospital or they may be obtained from a medical device supply store. Some insurance plans including Medicare may cover some or all of the costs for these items. An individual should consult their insurance provider to learn if they are eligible for this kind of coverage.
If an individual has dressings that must be changed, disposable medical supplies may be needed for this process. A professional caregiver or home health agency will usually provide these supplies. In certain cases, an individual’s doctor may provide the material for the dressings. Medicare does not cover items such as bandages or gauze.
Coordinating Medical Care
Following the procedure, the individual may receive a referral for physical therapy or occupational therapy. This type of therapy may take place in a medical setting or the therapist may travel to the person’s home. If the person must travel to the therapist and is not permitted to drive, they will need a family member or caregiver to arrange transportation.
Physical therapy plays an important role in assisting with recovery from the procedure and helps ensure that an individual regains as much independence as possible. People who have been prescribed physical therapy should attend all appointments and carefully follow the therapist’s instructions.
If the individual was sedated or anesthetized during the procedure, they are usually not permitted to drive home from the hospital. If they are taking medications that may cause drowsiness or if they have limited mobility such as an arm in a sling or a cast on their foot, they may be unable to drive for several days or weeks.
Under no circumstance should a person attempt to drive if a doctor has advised them that they are not medically fit to do so. Individuals who attempt to drive against medical advice may injure themselves or be involved in a serious accident. Caregivers can help discourage this behavior by arranging transportation for the individual while they are unable to drive themselves.
Depending on the person’s overall mobility, they may be able to resume their normal household routine soon after returning home. In some cases, however, they may need help performing household chores.
To minimize the risk of complications, an individual should be careful to observe any instructions or recommendations from the doctor regarding any limitations on their movement. They should not lift, push, or pull heavy items unless the doctor has confirmed that it is safe for them to do so.
Medical devices, implants, and grafts are often partially or completely covered by health insurance. However, if an individual requires additional health-related services such as physical therapy, additional equipment, or at-home care during their recovery period, these expenses may or may not be covered by their health insurance.
Caregivers and family members can help by contacting the health insurance provider ideally before or shortly after the procedure to determine which services will be covered. The Medicare website offers extensive information on this subject.
Selecting A Professional Caregiver
Caregivers often fall into two categories: those with medical training and those without medical training.
If an individual primarily requires help with household tasks and some ADLs such as bathing, dressing, or meal preparation, it may be acceptable to hire a caregiver who does not have formal medical training. This type of care is often referred to as custodial care. However, individuals with complex health needs may need skilled care from a medical professional.
Qualified home health care staff may have the following credentials:
- Registered nurse (RN)
- Licensed practical nurse (LPN)
- Certified nursing assistant (CNA)
- Home health aide (HHA)
Individuals and family members should ask prospective caregivers or home health agencies what kind of credentials the caregiver has and what type of training they have received.
Even if the individual does not require a caregiver with medical training, it may be desirable to seek out a caregiver who has valid CPR or first-aid certification so the caregiver is able to assist the individual in the event of an emergency.
Paying For At-Home Care
In some cases, an individual’s insurance provider may cover some or all of the costs associated with hiring an at-home care provider. However, the individual and their family will often be required to pay for care out-of-pocket.
Individuals who require temporary at-home care from a medical professional may receive some reimbursement from their insurance provider. Medicare may provide coverage for this type of care if the following criteria are met:
- A doctor certifies that an individual requires care from a skilled medical professional.
- The individual is homebound.
- The individual is under the care of a doctor.
- The individual requires only part-time/short-term care.
Most insurance plans do not cover non-medical services, such as help with housekeeping, cooking, or general companionship. However, Medicaid may provide custodial care coverage for certain individuals. The Medicaid website offers more information on Medicaid eligibility requirements and how to apply for coverage.
Making The Home Safe
If an individual will be cared for at home, certain home modifications may be needed in order to ensure the individual’s safety.
If the individual has issues with mobility, family members and caregivers should help prepare the home by:
- Removing rugs or securing them to the floor to prevent the individual from tripping
- Moving furniture and personal items to ensure the individual has a clear path to navigate through
- Installing handrails or grab bars near toilets, showers, and baths
- Placing a stool in the shower if the individual has difficulty standing for long periods of time
- Ensuring that the home is well-lit to prevent the individual from falling or tripping
- Securing electrical cords to the floor or moving them to another location
Individuals who live in a home with multiple stories may have difficulty going up and down a staircase. In some cases, it may be helpful for an individual to move their bedroom or other frequently-used items or furniture downstairs.
When Additional Care Is Needed
If an individual cannot be safely cared for at home, a long-term care facility may be required. Individuals who struggle to live independently or require round-the-clock care from a skilled medical professional are best suited to care in a long-term care facility.
If a person experiences significant complications following a procedure or if their health needs have become more complex, it may be time to consider making the move to a long-term care facility.
Residential Long-Term Care Options
Long-term care facilities may be sorted into three main categories:
- Independent living facilities
- Assisted living facilities (ALFs)
- Nursing homes
To select the best type of care facility, individuals and their family members will need to consider the level of care an individual requires.
Independent living facilities do not provide medical care. The facility may provide help with housekeeping, security, and general household maintenance. Individuals who need regular care due to serious health complications are usually not good candidates for independent living.
ALFs may be a good option for individuals who need more support than an independent living facility provides but do not require round-the-clock medical care. Some medical care such as assistance with medications is often provided in ALFs.
Nursing homes are often the best option for an individual who is no longer able to care for themselves and who may be experiencing complex health needs. Nursing home staff provide skilled nursing care along with help bathing, dressing, grooming, and toileting. A nursing home may also be the best option if an individual is not able to mobilize independently or suffers from cognitive issues such as dementia or Alzheimer’s disease.
Hospice care may also be an option for some individuals. Hospice facilities are most appropriate for individuals who are terminally ill or facing a life-limiting illness.
Selecting A Long-Term Care Facility
If it is necessary for an individual to enter a long-term care facility, family may help an individual make this decision by first determining what level of care is needed. At this stage in the planning process, a person and their family should also determine how they will pay for long-term care and which care options best fit their budget.
An individual’s doctor or health insurance provider may be able to offer recommendations for an appropriate facility. The Medicare website also offers a search tool to help individuals and families find long-term care facilities in their area.
Individuals and their family should also visit a facility to decide if it is a good fit. Some questions to ask facility staff include:
- Who will care for the individual on a day-to-day basis?
- What is the staff-to-patient ratio?
- What type of training or professional credentials do staff members have?
- In the event that the individual experiences a serious health emergency, how will the situation be handled?
- Who is allowed to visit? Are there set visiting hours or may family members come at any time?
- What precautions are taken to ensure residents’ safety and comfort?
Paying For Long-Term Care
Individuals and family members should begin planning for long-term care needs as early as possible. Many families struggle to pay for care if a person’s health insurance does not cover long-term care needs. Medicare provides coverage for certain long-term care options including hospice care and care in a skilled nursing facility (SNF).
However, there may be other options for paying for long-term care including using a life-insurance policy, using home equity loans, or applying for a long-term care policy. If an individual has a private health insurance plan, other long-term care options may be covered as well.
Financial And Legal Considerations
Individuals who plan to undergo a serious medical procedure may wish to make plans for who will assume control of financial or medical decisions should they become unable to make decisions for themselves.
A living will outlines an individual’s wishes for future health care needs. An individual may also choose to give a trusted family member power of attorney which would allow that person to make legal or financial decisions on their behalf.
It can be distressing to make plans in preparation for the possibility of becoming temporarily or permanently incapacitated. However, it is recommended that an individual and their family make these arrangements well in advance of a medical procedure to ensure that a person’s wishes are respected should the need arise.
Planning For Future Care Needs
Occasionally, a device or implant may need to be removed if:
- A doctor determines that the device/implant is no longer necessary.
- The device/implant has been damaged and must be repaired or replaced.
- The device/implant has been recalled.
Individuals should ask their doctor whether their device or implant is permanent and what their care needs might be if it must be removed or replaced. This information may be helpful for individuals and caregivers seeking to create a long-term care plan.
In most cases, a device, implant, or graft is placed because the doctor believes it will improve a person’s overall health. However, depending on the original illness or injury which necessitated the procedure, an individual may still need a greater level of care in the future. Family members may need to be prepared to assist with developing a long-term plan to cover future care needs.
FAQs About Complications After Receiving A Device, Implant, Or Graft
1. Do individuals with devices or implants need to make any special arrangements when traveling?
Any person with a medical device or implant should consult with their doctor to determine what type of travel is considered safe. In certain cases, individuals may be advised to avoid some security devices including x-ray scanners and metal detectors. If the individual must pass through security when they travel, they may need to request an alternative search such as a physical “pat-down” by security officers.
2. Is it safe to use cell phones, microwaves, or other devices near the device or implant?
It may be unsafe to operate certain electronic devices near a device or implant. These devices may include magnets, cell phones, security systems, or certain types of medical equipment that an individual may encounter at a doctor’s office or hospital. An individual’s medical provider will often provide information about devices that should be avoided.
3. Who should know about the device or implant?
An individual should inform their doctors, dentist, and other medical professionals that they have a device or implant. If an individual is advised to undergo any type of medical scan (including an x-ray, CT, MRI, or ultrasound), they should advise the person performing the scan what type of device or implant they have. An individual may also need to inform a massage therapist or physical therapist about their implant prior to receiving any services or treatments.
In some cases, an individual may need to inform security personnel about their implant since the implant may interfere with x-ray equipment or metal detectors. A doctor may provide more information about whether this type of equipment should be avoided.
4. What steps should be taken if the device/implant moves, comes out, or is damaged?
In rare cases, a device or implant may move, become damaged, or come out unexpectedly. If there is any reason to suspect that the implant is not functioning properly, a doctor should be consulted right away.
If the individual experiences severe pain, heavy bleeding, or suddenly loses consciousness, emergency medical care may be required. Call 911 or go to the nearest emergency room.
Proximity of care is very important when considering options
Research care options that are nearby when thinking about the next step for your loved ones.
Leona J. Werezak RN, BSN, MN is a registered nurse and adjunct nursing professor. She has 24 years experience working in a variety of healthcare settings including such remote locations as the Arctic Circle. Her research in early stage dementia was published in the Canadian Journal of Nursing Research and re-published in their 40th anniversary issue which showcased exceptional research published since the journal began. Her work in dementia care has also been published in the Journal of Gerontological Nursing. She currently teaches surgical nursing care on a thoracic/vascular unit to baccalaureate nursing students. Her clinical work with nursing students involves extensive work with older adults who have multiple chronic health conditions.