This information has been designed to give you a basic understanding of the considerations that need to be made when preparing for surgery.  Please keep in mind that this material is a reference only and your personal preparation may differ from that described.

Once you have decided to have surgery, preparing mentally and physically for surgery is an important step towards a successful result. Understanding the process and your role in it, will help you recover quickly and have fewer problems

Planning to go home

• Before you undergo any surgery, you will be given an idea of how many days you will need to be in hospital and what the limitations are after surgery
• Arrange for someone to be available to help out with every day tasks like cooking, shopping and laundry

Preparing for discharge

• Arrange for someone available to take you home before hand
• Avoid eating or drinking on the drive home, the combination of the moving car, anaesthesia and food can often cause nausea or vomiting.  After arriving at home, wait until you are hungry before you eat.  Begin with a light meal and try to avoid greasy foods for the first 24 hours
• Please take your pain medications as directed.  Using regular pain medications as directed will avoid sudden spikes in post operative pain which can be difficult to control.  Simple over the counter pain killers like panadol are very useful in reducing the need for heavier opiod based pain killers, reducing their side effects
• For pain medications which you have been advised to take as needed, take the medication as soon as you start becoming uncomfortable, but before you are in severe pain.  Most tablet pain medications take time to absorb in the gut before it starts working and if you wait until the pain is severe, you will have more difficulty controlling the pain.

Important information

• Emergencies: If you are suffering from chest pain, shortness of breath or another potentially life-threatening issue, do not delay - call 000 immediately.
• Surgical: To report a problem to Dr Chung, please call 1300 936 088.
• After-hours: If you have a significant concern after-hours, please present to the Emergency Department for review by a doctor.  Ask them to contact Dr Chung via the switchboard at Nepean Hospital

Things to watch out for:

• Bleeding
  • Bruising and minor ooze of blood from the wound is expected following surgery. 
  • Large or continued blood loss is rare and should be reported to Dr Chung immediately.
• Infection
  
  • Your skin is a natural barrier against infection.  Even with many precautions and protocols to prevent infection, any surgery that causes a break in the skin can lead to a wound infection.
  • Signs and symptoms of a wound infection include - redness, pain, swelling, warmth and fever.  Sometimes the wound may open and produce a white/yellow/green discharge (pus)
  • Please inform Dr Chung is you have any concerns
• Blocked drains
  • Occasionally the drain tubing can block.  You will notice the output of the drain decreasing substantially over the course of 1-2 days and there will be a swelling under the skin at the site of the surgery.  Your community nurse will usually be able to unblock the drain for you.

If you or your GP have any concerns, please contact us on 1300 936 088

Dressings

• Dr Chung routinely uses Comfeel dressing on most surgical wounds.  Comfeel is a waterproof dressing that you can shower over and pat dry with a towel.  Occasionally there may be a small bubble of fluid/ooze that collects under the dressing.  This is normal as long as it doesn’t leak.  The dressing should be left alone until your appointment to see Dr Chung.
• Occasionally on the face, ear or scalp, where adhesive dressings can be difficult to keep on, Dr Chung will use Dermabond glue as a dressing.  It looks like a purple film over the wound.  This film is waterproof and protects the underlying wound from infections.  You can shower over this but please avoid rubbing or scratching the wound as it can be “picked off”.

Drains

• Drains are plastic tubes left in the surgical field typically after lymph node clearance or removal of a large tumour to prevent the development of a fluid collection.  Some patients will be discharged home from hospital with the drain still in.  In those circumstances we will arrange for the local community nurse to review the drain on a regular basis and you will be asked to keep a diary of how much fluid has come out of the drain every day.
• The drain will be removed by Dr Chung in the rooms once the output is at an appropriately low level. 
• Removing the drain has an unusual sensation but not a painful one.  You do not require an anaesthetic for this.

Scarring

• Surgery involves cutting the skin to access the problem area.  A scar will form as part of the normal healing response.
• All scarring will improve with time.  Once Dr Chung has given you the all clear on your wound, you can start massaging it twice a day with Bio-Oil to reduce the prominence of the scar.  You will need to continue this process for a minimum of three months to have a noticeable effect.

Pain

• Please take your pain medications as directed.  Using regular pain medications as directed will avoid sudden spikes in post operative pain which can be difficult to control.  Simple “over the counter” pain killers like panadol are very useful in reducing the need for stronger opiod based pain killers and their side effects.
• For pain medications which you have been advised to take “as required”, take the medication as soon as you start becoming uncomfortable, but before you are in severe pain.  Most tablet pain medications take time to absorb in the gut before it starts to work and if you wait until the pain is severe, you will have more difficulty controlling the pain.
• Pain medications containing opiods can cause constipation.  If you are using pain medication such as Endone or Panadeine Forte, we recommend you take that with a regular laxative (e.g. 20ml lactulose) to keep your bowel functions regular.

Return to work

• Depending on your surgery, there may be limitations on what you can or cannot to at work
• Melanoma/Skin Cancer surgery
  • For surgery on the shoulders, back or legs we suggest avoiding heavy lifting or strenuous work until the wound has completely healed and the stitches removed (up to 3-4 weeks)
• Abdominal/keyhole/hernia surgery
  • We recommend avoid heavy lifting (>10kg) for at least 6 weeks after abdominal surgery and hernia surgery (keyhole or otherwise)

Return to driving

• There is no Australian legislation that covers surgery and driving
• Your normal car insurer may not cover you if you are involved in an accident and have had “recent surgery” or are under the influence of a strong pain medication
• To return to driving you should be able to drive, hit the break, turn the steering wheel 360 degrees and check your blind spots WITHOUT pain.
• Before driving on public roads, please practice in a safe and controlled environment (e.g. Empty car park)
• Please only consider returning to driving after you can safely and repeatedly perform all the emergency stop procedures and manoeuvres necessary for driving
• As a guide most people take at least 2 weeks to return to driving after major surgery