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General Information about operations
An operation is a procedure when a surgeon does something to someone's body. The whole process starts when you first see a doctor and involves patient information, consent, pre-operative investigations, admission to hospital for in patient or day case surgery, the operation itself, recovery and rehabilitation. This page covers the operation itself and recovery. Other parts can be seen by clicking on the links. Where do operations happen? Most operations are done in an operating theatre. Before an operation you will need to change into a surgical gown, like a large shirt. Normally, you will be taken to the 'pre-operative' area on a movable bed called a trolley. If you have daycase surgery then you may be asked to walk into the operating theatre. If you have a general or regional anaesthetic then you will have your anaesthetic given by an anaesthetist. If you have a local anaesthetic then the surgeon will often do one or two injections to numb the area that is to be operated on. The nurses who see you before the operation will explain in more detail what happens.
You should not eat or drink anything for six hours before the operation. In some cases, you may be allowed a drink of water a few hours before the operation. You do not have to shave any hair off before the operation but it is recommended that you have a bath or shower before the operation. Being clean, especially in any skin creases, is important as it reduces the chance of an infection. For some operations, it is essentially that you have a bath as infections of artificial grafts can be very serious. Will it hurt? An operation usually involves a cut in the skin. To stop the cut being painful, you will be given an anaesthetic. There are different types of anaesthetic: General, local and regional. What kind of anaesthetic will I get? This depends on the operation, your preferences and the advice of the anaesthetist. Most of the operations that Mr Braithwaite does use general or regional anaesthesia. He will be happy to explain more if necessary. What happens in an operation? Once you have had your anaesthetic, you will be on put the operating theatre table. Several things happen when you are ready for an operation: Shaving: It may be necessary to shave some hair from the area of skin that has to be cut. This will be done in the operating room. Sometimes it is necessary to use a process called diathermy to stop bleeding. For this to work, a metal plate has to be put on your skin, but not near the operation site. You may find that some hair has been shaved on one of your legs. The hair will grow back. Skin disinfection: Before the skin is cut it needs to be disinfected with a liquid called skin preparation. Mr Braithwaite usually uses a mixture of chlorhexidine mixed with either water or alcohol. You may return from the operation with pink skin where the solution has been used. Occasionally Mr Braithwaite uses iodine so it is important that he is told if you are allergic to iodine. Iodine will turn the skin brown. The disinfectant kills most of the bacteria that normally live on the skin and therefore this reduces the chance of infections after the operation. The colour of the disinfectant will wash off. Stitches: Mr Braithwaite usually uses a stitch hidden under the skin. This does not need to be removed. For some operations he uses clips that look like staples or a blue stitch made of polypropylene. These will need to be removed between 10 and 14 days after the operation. Often this is done at home by the district nurse. Catheter: For some operations, it is necessary to accurately measure how much urine is being produced by the kidneys. To do this, a tube needs to be passed into your bladder through the hole from which you urinate (urethra). The catheter will be removed as soon as it is safe to do so. Drip: During the operation it is often necessary to give you fluid. As you cannot drink during the operation and sometimes for a few days afterwards, it is necessary to put the fluid directly into the vein. When you have an anaesthetic, some small tubes (cannulae or venflons) may be put in. These can be used to give either salty water (saline), water with some sugar (dextrose) or blood. The venflons are also used to give medicines like antibiotics. Arterial line: For some operations, we need to measure accurately your blood pressure. This can be done by putting a tube into the artery. We usually use the artery near your wrist. The tube is removed after the operation or when you leave the high dependency or intensive care unit. Central venous catheter: For some operations we need to measure accurately how much fluid is in your veins and sometimes measure how well your heart is working. To do this a tube, often with several pipes, is put into your neck. The tube is removed after the operation or when you leave the high dependency or intensive care unit. Drains: Rarely, it is necessary to collect fluid that forms at the site of the operation. To do this, Mr Braithwaite leaves a tube attached to a bottle in place. This will be removed a few days after the operation. Chest Drain: If your surgery involves an operation in the chest cavity or near the chest then it may be necessary to leave a tube in the chest cavity. This is normally attached to a sealed bottle containing some water. It is normal for the tube to bubble. When the lung is fully inflated then the tube is normally removed. Dressings: After the wounds have been stitched up, Mr Braithwaite and the nurses in theatre use a large plaster or dressing. Sometimes Mr Braithwaite uses a clear dressing so that he can inspect the wounds after the operation. Bandages: Mr Braithwaite uses bandages for some operations. These will be removed soon after the operation or within a few days. Open wounds: For certain operations, Mr Braithwaite does not sew up the wound but leaves it to heal by a process called secondary intention. He will tell you if this is likely to happen. Click for more information What happens when the operation has finished? After an operation, you will be transferred to a recovery area within the operating department. Here you will be looked after by a nurse or operating department assistant until they and your anaesthetist are happy that you have recovered from your operation. Before being taken to the recovery area, you will normally have woken up from a general anaesthetic or any sedation that has been given for a regional anaesthetic. If you have some types of surgery, you may be transferred to the intensive care unit while still asleep. Mr Braithwaite will be happy to explain what happens if you have this type of operation. What happens in the few days after the operation? This depends on what operation you have had done. More information can be found on the pages about your operation. In general, Mr Braithwaite or one or more of the Junior surgical staff (registrar, senior house or junior house officer) will see you every day. Their visit may be for only a few minutes but they will check that you are getting better and will arrange for the staff involved in getting you better to be contacted. They should check your temperature and the other observations that the nurses have been doing. They may wish to examine you including your chest, tummy and legs. They will check that you are receiving the correct medicines. Depending on the operation you have and the progress you make, the staff will gradually remove the various tubes that have been put in for the operation until you are 'back to normal'. When can I go home? This depends on the operation you have had and the progress you make. Before your operation, the staff will try to give you notice of when you can go home but the situation can change depending on your progress. For some operations that make you less able either temporarily or permanently, it will be necessary for the physiotherapists and occupational therapists to make sure that you will be able to cope at home. Elderly patients may be referred to a rehabilitation team. What happens when I get home? You will feel tired when you go home and may find yourself falling asleep after only a little exercise. This is normal for some of the more major operations. Day by day you should get better but if there are any problems you should either contact the ward from which you were discharged or you own GP. Sometimes the ward staff will arrange for a District Nurse to visit you at home. If you have any concerns, do not hesitate to contact the hospital to talk to one of the ward staff. If necessary, they may contact one of the doctors. When can I return to normal activities? This depends on you and is a matter of common sense. If you feel comfortable then you can do what you want. Avoid driving until you can do safely do an emergency stop. Will I be seen again? Mr Braithwaite sees nearly all patients who have had an operation at least once in clinic. The appointment is usually 6-8 weeks after discharge but can be longer. What do I do If I am worried about the operation or my recovery? It is normal to be anxious before an operation. If you have any concerns, write them on a piece of paper and ask one of the staff before you have the operation. If you are worried about what has happened after an operation when you are on the ward then ask the doctors when they see you. Sometimes it can be difficult to ask questions. If this is the case, ask your nurse and they can ask the doctors on your behalf. If you are at home, ring the ward that you were on or your own GP.
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