Getting ready for surgery
As part of the Enhanced Recovery Pathway, it is important that you play an active role in your own care – before and after surgery – and include your family/carers and friends in this process. The more you put into your prehabilitation and recovery, the better your results are likely to be. There are a number of things that you can do to prepare for your surgery, accelerate your recovery and ensure the best outcome.
Your general health
Making sure your general health is as good as possible before your surgery can reduce the risks as well as help with your recovery.
- Make sure there are no cuts, grazes or wounds around the area when you come for surgery
- Lose weight if you need to – being obese increases the medical complications, including the risk of death, and adds to the risk of infection and the chance your surgery will fail
- Stop smoking – this can increase your chances of infection and the wound can take longer to heal
- Let us know if you have any skin conditions, including psoriasis, eczema, rashes or ulcers
- Avoid coming into contact with infections such as colds or flu and letting us know as soon as possible if you are unwell
- Don’t shave for at least three weeks before the operation. Shaving is known to increase infection rates in joint replacement unless it’s done immediately before the operation. It’s not known whether hair removal creams increase infection risk, so it’s best to avoid using these as well
- Arrange to have a flu injection at least a month before your surgery (or afterwards)
- Make sure you don’t drink above the recommended level as this can increase the risk of complications
- If you have high blood pressure, ask your GP to check that it’s well controlled
- Do any exercises you’re given before and after your operation
- Move about as much as possible after your surgery, as advised by your physiotherapist
- Wear elasticated socks for six weeks after surgery
Helping you to stay healthy
A healthy diet
Having a balanced diet will ensure your body has the right balance of nutrients for recovery.
If you’re overweight or obese, it can help to reduce your risks of surgery if you lose some weight before surgery.
Do you smoke?
If you smoke, try to stop at least eight weeks before your surgery if possible. Not only is smoking linked to heart and respiratory diseases, it can also increase the risks of anaesthesia.
There is a higher risk of complications than in non-smokers. These include:
- Bones take longer to heal in smokers because nicotine affects bone-forming cells
- Poor wound healing
- Less satisfactory final outcomes
If you can quit smoking 24 hours before surgery, or even cut down, you can help improve the outcome of your surgery/reduce the risk of respiratory problems during anaesthesia.
You can find help here.
Do you drink more than the recommended amount of alcohol?
If you drink heavily, then it’s important that you reduce your alcohol intake or stop altogether 3-8 weeks before your surgery – this will significantly reduce the risks of serious post-operative complications. Heavy drinking affects your immune system and means you’re more likely to have complications after surgery, including infection and slow healing.
More advice about cutting down or quitting is available here.
Working with your healthcare team
Research has shown that patients who engage more with improving their own health and are well informed – have better outcomes. If you take an active interest in your surgery and treatment, it means you’re more likely to feel positive about working with your healthcare team to prepare for your surgery, including carrying out your strengthening exercises and asking questions so that you’re well informed and feel in control of your health.
The healthcare team supporting your Consultant includes the following professionals:
- Anaesthetist – a doctor who will be responsible for giving your anaesthetic, pain relief immediately after surgery, and for your overall safety and wellbeing during the operation. Most joint replacements are carried out under regional anaesthesia but you’ll have an opportunity to discuss this before your surgery so that you can be confident this is the most appropriate anaesthetic for you. There’ll also be a chance to discuss any worries or concerns you may have about anaesthesia.
- The ward nurse who will explain more about what to expect when you arrive at hospital, during your stay, and how to avoid infections before your surgery
- Physiotherapist who will advise you on exercises to assist in your recovery and give you advice on managing your daily life after your surger
Strengthen your muscles so that recovery is easier
Having good upper body strength and losing weight if you need to can make it easier to get around after your surgery. Following the programme of strengthening exercises advised by your physiotherapist can also help to speed up your recovery.
Before your surgery, prehabilitation exercises will increase your flexibility and strengthen the muscles. The more often you carry out these exercises, and the stronger these muscles are before surgery, the faster your recovery is likely to be.
You should start doing these exercises before your surgery to help improve the movement and strength in your muscles.
The physiotherapy team on the ward after your operation will monitor your exercise and for best results you should carry out the exercises given independently at least three times per day.
It’s also very important that you continue to do these exercises when you leave hospital in order to get the best outcome possible for you.
Preparing your home
When you first return home after surgery, you won’t be as mobile as usual and this may restrict what you’re able to do. Try to work out a plan with friends and family who can help you or arrange for some additional help while you recover from surgery. Making some adaptations around your home before your operation can make life much easier later on. These might include:
- Clearing pathways through halls and rooms, getting rid of clutter and moving furniture if necessary as well as loose rugs that may trip you up
- Moving kitchen items, such as mugs and plates, into cupboards that you can easily reach without bending down
- Buying a nightlight if you think this may help you feel more confident moving around at night
- Buying or making some ready meals that are easy to prepare and putting these in your freezer along with bread, milk, etc
- Bring any household tasks up to date (eg cleaning and washing)
- Arrange any help you need with housework, cooking and looking after pets
- Devices like reachers or long-handled shoe horns can help after surgery.
- Keep phone numbers of the hospital, your GP and people who can help you handy
The downloadable checklist below is designed to help you prepare for going to hospital and when you return home. You might like to talk it through with a friend, carer or relative to make sure you have practical support in place:
My to do list
- I know the date I am likely to return home have told people where I am going to be
- I have packed a bag with everything I need (see hospital checklist )
- I have a list of any questions I need to ask
- I have arranged for transport to hospital and back home
- I have arranged care for any relatives
- I have arranged for someone to look after my pets
- I have cancelled milk/papers as necessary
- I have moved any loose rugs/furniture that might cause problems
- I have made sure I can easily reach what I need
- I have made any modifications to my home as advised by my healthcare team
- There is additional milk/bread in the freezer
- There are some ready-made meals in the freezer