Preparation for surgery

Washing – all areas soon to be operated on should be thoroughly washed the evening before planned surgery.

Shaving – Patients often wonder if it would be helpful to shave an area prior to surgery. Sharp (razor) shaving causes micro-trauma to the skin surface, which can increase the risk of peri-operative wound infection. I do not recommend pre op shaving of the surgical site though removing hair with electrical clippers would not be an issue if a patient wished to do so.

In surgery I aim to remove only the necessary amount of hair to perform the procedure safely and adequately. I can perform surgery through minimal hair shave incisions if requested by the patient.

Eating and drinking:

You must not eat or drink for a minimum of six hours prior to general anaesthesia or sedation. If your procedure is in the morning this means nothing to eat or drink after midnight. Just in case the list order changes even if your surgery is planned for the afternoon we would usually advise no eating or drinking on the day of surgery. Your anaesthetist may sometimes allow a small amount of water up to two hours before the procedure, but only have this if the anaesthetist advises you can specifically.

Blood Thinning medications:

Medicines such as Warfarin, Clexane, Clopidogrel (Plavix /Iscover/Piax) aspirin and dipyridamol are designed to thin the blood and reduce the chance of blood clotting. Whilst these are very important medications, they may significantly increase the risks of any surgery, but particularly brain and spine surgery. In order to perform the surgery safely a plan must be made for stopping the medications. The duration of stopping the medicines will depend on how critically reliant you are on the medicines in the short term. We will together with the doctor who prescribed the medicines make a plan for both stopping and restarting the medications around the time of surgery. This is a very important step and if you are taking these medications you must inform me and understand the plan we make. If you have any questions about these medicines it is best to discuss them at least two weeks before your surgery as some of the medications take this amount of time to fully leave your system.

What to bring to hospital:

• Yourself!
• Inpatient clothing and footwear – Light fitting clothes that are comfortable and easily washed, and sensible shoes for indoor wear.
• Bathroom accessories – Toothbrush and toothpaste, comb / hairbrush etc.
• Scans
• Medical History
• Emergency Contact details

How to plan for after the surgery

Following discharge you will most likely need help at home. Ensure that your support network are well prepared and are on hand to provide assistance. Whatever surgery you have had, you will be fatigued and will tire more quickly than usual. This will mean your activities are reduced and you will most likely need time off work. We will discuss this prior to your surgery.

Rehabilitation:

If you are recovering from a functional deficit you may require rehabilitation to maximize your recovery. This will mean spending extra time in a rehabilitation facility before going home where there is more limited access to medical staff but lots of physiotherapy and other therapists to ensure your return to home is smooth and safe. If you have a limited support network at home rehabilitation may also be suitable to provide you with support until you are functionally more recovered.