New York Hand Surgery

Preparing for Surgery & Procedure

Preparing for Surgery

Once you and your Doctor decide that surgery will help you, you will need to learn what to expect from the surgery and create a treatment plan for the best results afterward. Preparing mentally and physically for surgery is an important step toward a successful result. Understanding the process and your role in it will help you recover more quickly and have fewer problems.

Working with Your Doctor

Before surgery, your doctor will perform a complete physical examination to make sure you don’t have any conditions that could interfere with the surgery or the outcomes. Routine tests, such as blood tests and X-rays, are usually performed a week before any major surgery.

  • Discuss any medications you are taking with your doctor and your family physician to see which ones you should stop taking before surgery
  • Discuss with your doctor about options for preparing for potential blood replacement, includes donating your own blood, medical interventions and other treatments, prior to surgery
  • If you are overweight, losing weight before surgery will help decrease the stress you place on your new joint. However, you should not diet during the month before your surgery
  • If you are taking aspirin or anti-inflammatory medications or warfarin or any drugs that increase the risk of bleeding you will need to stop taking them one week before surgery to minimize bleeding
  • If you smoke, you should stop or cut down to reduce your surgery risks and improve your recovery
  • Have any tooth, gum, bladder or bowel problems treated before surgery to reduce the risk of infection later
  • Eat a well-balanced diet, supplemented by a daily multivitamin with iron
  • Report any infections to your surgeon. Surgery cannot be performed until all infections have cleared up
  • Arrange for someone to help out with everyday tasks like cooking, shopping and laundry
  • Put items that you use often within easy reach before surgery so you won’t have to reach and bend as often
  • Remove all loose carpets and tape down electrical cords to avoid falls
  • Make sure you have a stable chair with a firm seat cushion, a firm back and two arms

Preparing for Procedure

If you are having Day Surgery, remember the following:

  • Have someone available to take you home, you will not be able to drive for at least 24 hours
  • Do not drink or eat anything in the car on the trip home
  • The combination of anesthesia, food, and car motion can quite often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours
  • If you had surgery on an extremity (hand or elbow), keep that extremity elevated and use ice as directed. This will help decrease swelling and pain
  • Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty in controlling the pain

Pre-operative Instructions

  1. Please call the hospital to schedule your pre-admission appointment to sign consent forms and discuss financial matters and anesthesia prior to surgery. If indicated you may also require some blood tests and an EKG.
  2. In case medical or cardiac clearance is required for the surgery, it should be submitted at least a week prior to the surgery. This is crucial as surgery cannot be performed until the clearance is received.
  3. Please stop taking all aspirin products, herbal or vitamin supplements and anti-inflammatory medicines such as Ibuprofen, Advil, Aleve and Motrin at least seven days prior to the surgery. If you are on blood thinning medications such as Coumadin, Plavix and Warfarin, ask your doctor about the discontinuation of this medication prior to the surgery. This is crucial as these medications increase the risk of bleeding and complications of anesthesia. If required Tylenol (Acetaminophen) may be taken prior to surgery for pain relief or headache.
  4. Please inform your doctor about all the medications you are currently taking and clarify as to what can and cannot be taken prior to the surgery.
  5. Please inform your doctor of any change in your medication between your pre-operative visit and the day of the surgery.
  6. Also inform your doctor if you develop any illness prior to surgery even if it’s a minor problem such as a skin problem or a cold. An infection in the body increases the risk of operative site infection. The lungs should be clear before giving any local, regional or general anesthesia. If the doctor feels that the change in health will affect the outcome of the surgery, the surgery may be postponed to a later date.
  7. If you are unable to undergo the surgery, for any reason, kindly inform the doctor as soon as possible.
  8. Unless instructed otherwise, “Do Not Eat Anything after Midnight Prior to Your Surgery”. You may be allowed to take certain medicines, with a small sip of water, on the day of the surgery.
  9. Shower with an antibacterial soap prior to the surgery to help prevent infection. However, this can be skipped if you are advised to wear a cast or splint.
  10. Please make arrangements for someone to drive you home after the surgery as you will not be able to drive yourself home.

Post-operative Instructions

Apart from the specific instructions given to you depending on the type of surgery you have undergone, the basic general instructions that you should follow after your surgery are as follows:

  1. Take pain relieving and other medications as advised. Pain relieving medication should be taken with food. After the first 48 hours of surgery, take the pain medication only when needed.
  2. Do not drink alcohol, drive a vehicle, operate any machinery or sign a legal document for the first 24 hours after the surgery as the effect of the sedative and/ or the aesthesia administered during the surgery may last for the first 24 hours of the surgery.
  3. Use ice packs to control swelling. However make sure that the ice bag does not leak into the dressing. Ice packs can be used liberally for the first 48 hours and even later, if required.
  4. Follow the specific restriction of activity, as advised. Remember that it is easier to prevent developing pain rather than managing it once it has already developed. Rest for a few days after the surgery and keep the operated extremity elevated, above the level of your heart, to control swelling.
  5. Keep the dressing clean and dry to promote wound healing.
  6. Try to begin physical therapy a day or two after the surgery. Exercises in the first week are usually aimed at regaining joint motion. Strengthening exercises are initiated later. Regular exercises are critical for a successful outcome.
  7. Eat a healthy diet and drink plenty of non-alcoholic and non-caffeinated drinks.
  8. Schedule your follow up appointment with your doctor as advised.

Please consult your doctor immediately if you experience any of the following symptoms:

  • Increased drainage from the incision
  • Increased redness around the operated area
  • Increased swelling that does not decrease with ice and elevation
  • Foul odor
  • Fever greater than 101°F
  • Coldness, numbness or blanched white or bluish color of the fingers or toes
  • Sudden calf pain or shortness of breath
  • Chest pain

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