Pre and Post Op Advice

Before Surgery

When we confirm your surgery, we will tell you when you should stop eating and drinking in order to be ready for a general anaesthetic. If you are having a local anaesthetic, there is no need to stop eating or drinking prior to 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. It is best to arrive freshly bathed, without makeup or skin preparations, and with clean hair and nails. There is no longer any need to remove nail varnish from toes and fingers. You should wear comfortable clothing which is easily removed.  Front buttoning tops are best for any surgery to be performed on the head and neck.

We ask that you 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, you are strongly advised to stop taking these medications six weeks before the date of your operation. You may resume two weeks after the surgery. You should contact your Family Doctor to discuss another method of contraception to cover the interval.

Finally, we ask you to discontinue 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.

After Surgery

To achieve the best possible result after surgery, it is important that the wound, the sutures (stitches) and, later, the scars are given proper care. If you wish to take pain-relieving tablets after leaving hospital, paracetamol (Panadol) are best. Avoid aspirin, or aspirin-containing compound preparations, since these can encourage a new wound to bleed. Medications containing non-steroidal anti-inflammatory ingredients (like Nurofen, Brufen, Ibuprofen, Ibuleve etc) can occasionally do the same, but they are better than aspirin in this regard. After any operation, it is beneficial to elevate the affected part to reduce swelling and discomfort. If you have had an operation on your face, you may find it helpful to sit up rather than lying flat for the first day or so, and to sleep with extra pillows for five days. If the operated part is a hand, for example, you may find it helpful to elevate it on pillows at night and in a sling during the daytime. Similarly, if the operated part is a leg it should be rested on a footstool as much as possible if there is swelling.

Wounds may be 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 is variable 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 left beneath the skin to provide support to the layers of the wound; 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 removed. When you are able to begin washing the area again, do so 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. Should your wound continue to bleed, or become red, inflamed, oozing or tender, you should contact us immediately.

One week after sutures are removed, provided that the wound in soundly healed, the regular application of a small smear of a silicone preparation such as Silgel or Dermatix (used according the manufacturer’s instructions) will encourage any pinkness in the scar to fade. From around one month after the stitches are out and the wound soundly healed, Mr Gault sometimes recommends 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 fade 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 full maturation process usually takes nine months to one year but varies according to individual skin types. Those with red hair and fair skin tend to develop scars which stay redder longer than those with a darker complexion.