Pre and Post Op Advice
Once you have booked a date for your surgery, we will write to you to formally confirm the details. If your surgery is to be performed under general anaesthetic, we will tell you when you should stop eating and drinking. If you are having a local anaesthetic, there is no need to stop eating or drinking before your surgery.
Please arrive on time, as you will need to be registered at reception, seen by the nursing staff and by your anaesthetist (if you are having a general anaesthetic or intravenous sedation (twilight anaesthesia) and Mr Gault before you go to theatre. Please arrive freshly bathed, without makeup or skin preparations, and with clean hair and nails. There is no longer any need to remove nail varnish or false nails from toes and fingers. You should wear comfortable clothing which is easily removed. Front fastening tops are best for any surgery to be performed on the head, neck, chest, back and arms so that they do not need to be pulled off over your head.
Please discontinue aspirin medication SEVEN days pre-operatively, Warfarin FOUR days pre-operatively and garlic and ginko tablets two weeks pre-operatively (these medicines can cause unwanted bleeding after surgery).
Because of the increased risk of thrombosis in patients who have major surgery under general anaesthetic when on the contraceptive pill and hormone replacement therapy, please stop taking these medications six weeks before the date of your operation. You can restart two weeks after the surgery. Please contact your Family Doctor to discuss another method of contraception to cover the interval.
Finally, please stop Valerian- and Kava-containing herbal medicines two weeks before surgery if you are having a general anaesthetic as these medicines can increase the sedative effects of the anaesthesia.
To achieve the best possible result after surgery, you should give proper care to the wound, the sutures (stitches) and, later, the scars. For pain relief after leaving hospital, paracetamol (Panadol) are best. Avoid aspirin, or aspirin-containing compound preparations, because these can encourage a new wound to bleed. Medications containing non-steroidal anti-inflammatory ingredients (like Nurofen, Brufen, Ibuprofen, Ibuleve etc) can occasionally also encourage bleeding, but less so than aspirin . After any operation, elevate the affected part to reduce swelling and discomfort. If you have had an operation on your face, sit up rather than lying flat for the first day or so, and sleep with extra pillows for five days. If the operated part is a hand, for example, elevate it on pillows at night and in a sling during the daytime. Similarly, if the operated part is a leg, rest it on a footstool as much as possible if there is swelling.
Wounds may be stitched (sutured) in a variety of ways. Non-dissolving stitches must be removed; Mr Gault prefers to do this himself and will ask the secretaries to arrange an appointment for this. The timing of suture removal varies and depends mainly on the site of the wound. For the face it is usually between two and eight days but for surgery elsewhere, the sutures may stay in as long as two or three weeks. Mr Gault does not use staples to close wounds.
Dissolving stitches are often left beneath the skin to provide support to the deeper layers of the wound to allow it to heal perfectly and without an indentation; occasionally your body does not dissolve them and instead extrudes them (pushes them out), so that they appear just beneath or through the wound, often several months after surgery.
Please keep your wound and the dressings completely dry until you have been seen for review and your stitches have been removed. When you are allowed to wash the area again, do this gently with soap and water and pat dry with a clean towel. Do not pull at the wound or soak it or pull off dressings which are stuck as this can remove the healing tissue, or make the wound bleed or stretch. If your wound continues to bleed or becomes red, weeping, inflamed or tender, you should contact us immediately.
One week after sutures are removed, provided that the wound is well healed, use a small smear of a silicone preparation such as Silgel or Dermatix (used according the manufacturer’s instructions) to fade any pinkness in the scar. From around one month after the stitches are out and the wound healed, Mr Gault may recommend that the area is gently massaged with one finger only and a little moisturising cream twice each day for three months. This will soften the scar and help it to settle more quickly.
Try not to scratch your scar as it may stretch. If itching is a problem, Eurax ointment may help.
Most scars take three months to reach full strength, and during this period are active, red and a little raised. After this they fade and flatten: this process usually takes nine months to one year but can be eighteen months. Those with red hair and fair skin tend to develop scars which stay redder longer than those with a darker complexion.