After an open splenectomy for a ruptured spleen, what is the most important instruction for the patient prior to discharge?

Following an open splenectomy, one of the most critical aspects of post-operative care is the risk associated with asplenia, or the absence of the spleen. The spleen plays a crucial role in filtering bacteria from the blood and in the immune response. Therefore, patients who have undergone splenectomy are at an increased risk for infections, particularly from encapsulated organisms such as Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis.

Vaccinations are an essential preventive measure to help protect these patients from infections. Specifically, it is recommended that patients receive vaccinations against these organisms prior to discharge, or as soon thereafter as they are well enough. This helps to bolster their immune response and reduce the likelihood of serious infections.

The other options, while relevant to overall patient care, do not address the immediate post-operative needs and risks associated with spleen removal as directly as the vaccination follow-up does. Resuming normal activities right away, taking aspirin, or even regular blood pressure monitoring, although important in a general sense for recovery, do not specifically mitigate the heightened risk of infection post-splenectomy.