DIEP?; c) What are the side effects?; and d) Why should the patient select this procedure?The nurse can explain to the patient that the DIEP procedure involves donation of fatty tissue from the abdomento the breast(s). The DIEP does not involve transfer of muscles as do some other procedures. One result of themastectomy is that the breast(s) will be numb. The numbness will not be painful, and will become less noticeableover time. Donating tissue from the abdomen also causes the abdomen to become numb. The numbness will feelnew and strange, but will generally not be noticeable after several weeks.The initial tissue donation from the abdomen will not be the final procedure. Most people undergoing the DIEP willhave three surgeries with about three months between procedures: a) DIEP with abdominal tissue donation, b)breast augmentation - liposuction from the thighs to fill in the breast skin to the desired size and look, and c) re-building or tattooing the nipples and areola. The first procedure may occur simultaneously with a mastectomy, andrequires a 2-3 month recovery with actual time off from work. The next procedure takes about 10 days for initialrecovery with an additional two to four weeks for bruising and stitches to fade. Recovery from the third procedurevaries, depending on the procedure selected.Activity/rest: Risk for activity intolerance. Before surgery, encourage patients to do as many of their favoriteexercises as possible to a) improve strength for surgery, and b) enhance circulation for new tissue. Patients shoulddo push-ups from their knees, toes, or from the wall while standing to improve upper body strength andcirculation. They should work to complete sets of 5-10 push-ups, 3-5 times per day. The arms may become sore,which is normal. Push-ups will also improve strength and circulation to the upper body after surgery, so as topromote healing.By exercising preoperatively, the mind is prepared for physical pain as a result of some suffering during thepreoperative period. Lifting weights and swimming are also excellent activities to build upper body strength andcirculation in preparation for the DIEP procedure. Sleeping 6-8 hours per night before surgery as often as possible
Research is neededto explore theimpact of takingvitamins... beforesurgery.is imperative so that the cells are rested. The nurse can also discuss with a patient how to promote adequate,quality sleep.Food/fluid: Readiness for enhanced nutrition. Encourage patients to eat abalanced diet with some carbohydrates, protein, fruits, and vegetables, and toreduce sweets every day for several weeks before surgery to put the body in thebest condition for post-operative healing. Research is needed to explore theimpact of taking vitamins (e.g., vitamin C, vitamin D, and fish oil) before surgery.