Day surgery

You must stay ‘Nil by Mouth’ before the surgery. This means you should: -

• not eat any food/sweets (including chewing gum/mints) after midnight the night before
• drink only water up until 6am.

After 6am you should not have anything else to eat and drink unless told to by the anaesthetist or the ward staff. 

Please bring your medication with you, so that it can be taken if needed.

If you are being brought in for an afternoon operation you may be given different instructions about eating/drinking over the telephone.

Pre-surgery 
If your operation is at the end of the day you may need to stay overnight for observation. Please leave your valuables at home. On the morning of your operation, have a shower/full wash (keep your cast dry if you have one). Do not apply make-up as you will be asked to remove it.

What to bring

• Loose fitting day clothes to wear during your stay: shorts/skirts/tracksuit bottoms, underwear
• Shoes: trainers/slip on shoes which are easy to remove, slippers to walk to theatre in if you prefer
• Nightwear: lightweight dressing gown, pyjamas/ nightdress
• Washbag containing toiletries and soap
• Entertainment/books/magazines/music/phone charger
• Regular medication
• Contact details of the person who will be accompanying you home

Your team will talk you through the process. Further paperwork will be completed and final checks on fasting and medication will be undertaken prior to your visit to the operating theatre. 

Before your operation, you will have your heart rate, blood pressure and temperature checked. Your Surgeon and Anaesthetist will see you, consent you for the operation and answer any questions about the procedure on the day.  They may mark an arrow on the skin to indicate a side to be operated on. Do not wash off this arrow.

Nursing staff will let you know approximately what time you will go for your operation. When it is time for your surgery you will be asked to change into a surgical gown and you will be taken to the theatre. 

You will meet your anaesthetist before your operation. They will ask you questions about your health, previous anaesthetics and your usual medication. They may need to examine your chest with a stethoscope and examine your neck and mouth. Please ask questions and tell them of any worries you may have. The anaesthetist will explain the anaesthetic options for your procedure.  They may discuss General, Spinal, Blocks and Local anaesthesia with you. 

• General Anaesthesia
  A general anaesthetic means that you will be asleep throughout the procedure and will have no recollection of the operation itself. You will remember going to sleep and waking up in recovery after the surgery has taken place. 
• Local Anaesthesia
  Local anaesthetics are drugs that have a numbing effect. You will feel no pain but you will be able to feel pressure.  You will be awake throughout the procedure and able to chat with the theatre staff. 
• Spinal Anaesthetic
  Local anaesthetic is injected near the nerves in your back.  This makes you go numb from the waist to the feet.  You will not feel pain but will remain awake and able to chat to the theatre staff unless you request for a sedative to help you fall asleep. With sedatives you are likely to have little memory of your time in theatre due to falling asleep.
• Nerve Block
  This is an injection of local anaesthetic near to the nerves that supply that area. You should feel numb and pain-free for up to 48 hours afterwards. You may also not be able to move the affected limb properly during this time. The block may be performed in combination with other anaesthetic types. 

You should not smoke prior to having an anaesthetic. 

Pain following an operation is expected and usually persists for a few days or sometimes weeks after surgery. Medication is used to control this to an acceptable level.

Different operations lead to varying degrees of post-operative discomfort and everyone experiences pain differently. We aim for your pain to be at an acceptable level on movement and should not prevent any physiotherapy (if needed), mobilisation or general function.

Pain relief is available in different forms and strengths. There are doctors and nurses on your ward who can help you with your pain and it is important to let someone know if the pain relief is wearing off and you are feeling uncomfortable.

With all drugs there are some side effects; these may include nausea and vomiting, constipation, headache, dizziness, feeling sleepy and sometimes mild confusion. These side effects can be treated by the ward staff so please let them know.

It is vital that you tell the nurse or doctor if you have any allergies to any medication, if you have experienced a stomach ulcer or similar problems from pain relief in the past or if you in are on any pain relief already. This information will help identify the most suitable type of pain relief for you. 

Discharge medication ‘To Take Out’ (TTO’s)

You may be prescribed painkillers to take home with you. Always continue pain relief as required and take them as directed. Do not exceed the stated dose. Further supplies can be obtained from your GP or local pharmacy. 

The vast majority of day surgery operations require simple painkillers afterwards - please ensure that you have a supply of these at home. If you require stronger pain relief, you will be prescribed these prior to discharge. 
 

Reducing the risk of infection in hospital

At Hampshire Hospitals, we take the prevention of infection very seriously. Whilst we have a dedicated infection prevention team, we believe that controlling infection is everyone’s business and maintaining a clean and safe hospital environment is a priority for all our staff.

What can you do to help reduce healthcare infections?

If you are a patient: 

• Please take a shower or bath before coming in for surgery
• Don’t be shy – ask if equipment, such as blood pressure machines or drip stands have been cleaned prior to use on you
• Ask our staff politely if they have cleaned their hands with alcohol gel or soap and water before attending you
• Always wash your hands after going to the toilet and before eating and drinking
• Please use the alcohol hand gel provided at all the main entrances
• Tell a member of staff if you notice dirty areas in the hospital e.g. toilets
• Please tell your nurse or doctor if you have a drip, drain or catheter that becomes sore so that they can change it if necessary
• Please take the whole course of any antibiotic medicine you are given

For visitors

• Please wash your hands or use the alcohol before and after visiting a patient in the hospital
• Not more than two visitors at any time around the bed and any children visiting must be always supervised so that they do not touch dressings or equipment
• Please check with the nurse in charge before visiting a patient if you have a medical condition that makes you vulnerable to infection
• Please do not visit a patient if you are unwell yourself 
• Please do not sit on the bed

General Wellbeing
It is not unusual to feel tired after surgery and your sleep patterns may take a while to return to normal. Remember to keep the affected limb elevated to try and reduce swelling.

Your appetite as well as your bowel habits may take a while to recover. Make sure you drink plenty of fluids and try to eat a healthy balanced diet.

Try not to feel frustrated at not being able to do all the things you want straight away. Increase your activity levels gradually. Start with short distances and increase as you feel able. 

Controlling pain and discomfort
Take your pain medication as directed.  Try not to sit too long in one position during the day. Stand up and have a stroll or change your position in the seat. 

TED Stockings
If you have been told to wear your TEDS or ‘Anti-Embolic’ stockings at home, these must be worn day and night following your operation. They should be hand-washed and dried away from direct heat to preserve their beneficial effect. 

Medication
Restart all medication as directed on your discharge summary.

Wound care and plaster care
It is important that you keep your wound and/or plaster cast dry until it is reviewed in clinic or at the GP. 

Do not be tempted to remove your plaster cast or dressing as this could lead to infection.

If you have sutures (stiches) or clips these may be taken out in the fracture clinic or by your GP. The nursing staff will advise you on this before you are discharged.

You may feel tingling, numbness or itching as your wound heals. You may also feel a slight pulling around the stitches or staples and a hard lump forming. These are perfectly normal occurrences and are part of the healing process.

Some signs are not normal: if you are concerned that the skin around your wound has become red, sore, hot or swollen, if there is a green or yellow coloured discharge or if you feel generally unwell, feverish or have a temperature, please visit your GP or ring 111.

If you are feeling very unwell go to the Emergency Department

Driving
You should not be driving until it is safe to perform an emergency stop and change gear comfortably. You must inform your insurance company about your operation. It is your responsibility to decide when you are safe to drive again. Your consultant can advise you on this if needed.

Return to work
This is dependent on the type of operation you have had but may take up to a few months. This may be longer if you have a manual job and your consultant will advise you on this.

Consultant follow up
Most patients do not require a follow up appointment but if this is required it will be noted on your discharge summary and you will be sent a letter in the post.