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Dr. David Savage

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Surgery Checklist

Once you have decided to have orthopaedic surgery, you should become familiar with the expectations both before and after surgery, including recovery.

Pre-Op Checklist

Prior to having orthopaedic surgery, there may be certain things you need to do. These things will depend on your age, health, and the type of surgery being performed.

Many times a visit with your primary care physician will be recommended or required. This allows for a careful evaluation of potential conditions that could increase your risk of problems around the time of surgery.  An example would be poorly controlled diabetes that would lead to an increased risk of infection after surgery.

Sometimes it is necessary to take vitamins or supplements prior to surgery. A common example is an iron supplement. This is taken to help prepare the body to manufacture new blood or tissue following the blood loss and surgical trauma that goes along with all surgeries.

If you have a history of cardiac disease, your cardiologist will usually need to indicate that your cardiac condition is optimized for the planned surgery.

If you are having a joint replacement such as knee or hip replacement, then you may need to see your dentist prior to surgery. This is because poor dental health can lead to infections in the mouth that can sometimes spread via the blood stream and cause an infection in the prosthetic joint replacement. If there are broken or poorly maintained teeth, it is often recommended to have these extracted or repaired prior to undergoing joint replacement surgery.

It is important not to eat or drink for 8 hours prior to scheduled surgery. At times you will be instructed to take certain medicines with a small sip of water on the day of surgery during the 8 hour period before surgery.  This should only be done if instructed by one of your physicians and only with the smallest amount of water needed to allow you to swallow the pill.

You will need someone to drive you home from any surgical procedure or hospitalization. Plan ahead to determine who will be able to do that for you.

Post-Op Checklist

Plan to see Dr. Savage as directed at your pre-operative appointment or at the time of your hospital/surgical center discharge. Patients are typically seen 10-14 days after most surgeries for removal of sutures if needed (some procedures have sutures that dissolve and do not require removal).

Bandages can typically be removed and left off 4-5 days after the surgery. At this time, if the incision site is clean and dry, then bathing and showering are allowed without any covering on the wound. Prior to this time, the wound must be covered with plastic or kept out of the bath/shower water.

Ice and elevation of the affected part helps to reduce pain and swelling after surgery.  Ice packs or cold packs (bags of frozen peas work great) can be applied over the bandage but should never be applied directly over exposed skin to prevent cold injury of the skin.

Some surgeries require patients to take blood thinners by injection or pill after surgery to reduce the risk of blood clot formation. This is commonly done after hip or knee replacement surgery and after some types of fracture surgery.

Please notify Dr. Savage at once if you notice any of the following:

  • A high fever of 101.5 degrees Fahrenheit or higher
  • Excessive or persistent drainage on the bandages beyond the first 48 hours
  • Excessive redness around the incision site
  • Unusual or unexplained tenderness in the leg or sudden increases in swelling (these can be signs of a blood clot)

Please be aware that with many surgeries, you may not feel a great deal of pain on the day of surgery. Due to the time needed for maximal inflammation to occur, and for some anesthetics to wear off, patients often report increased pain the second day or evening after surgery.

Common side effects of many pain medicines include itching, nausea, and vomiting. If these are excessive, please call to discuss alternative options.

Recovery Expectations

Patients are all anxious to get back to an active lifestyle after surgery.

The specific activities allowed will depend on the surgery performed and how well you as a patient are recovering.

People commonly want to know when they can drive. This requires that patients not be on narcotics for the 4-hour period prior to operating a motor vehicle. It also requires the dexterity to safely control the vehicle with hand and arm controls as would be required in an emergency, such as having to swerve or slam on the brakes. If pain, swelling, or weakness inhibits your ability to safely control the vehicle in an emergency, then you should not be driving. 

If you had leg surgery, there may be restrictions on the amount of weight you are allowed to put on that limb when walking until a certain amount of healing time has passed. This varies based on the injury and/or surgery performed. Similarly, after arm or hand surgery, there are often restrictions as to how much you can move or how much weight you can lift. Ask Dr. Savage for specific recommendations as they pertain to your diagnosis and surgical procedure.

Returning to work is dependent on the diagnosis and treatment rendered. The demands of the job will also dictate to some degree the speed with which patients can return to work. More sedentary office type jobs are usually easier to return to than physically demanding occupations like construction work.  Dr. Savage can give you specific advice.

Patients often have questions about when they can travel, return to sports, or engage in sexual activity after surgery. These questions are important and the answers depend on the diagnosis and treatment.  Ask Dr. Savage about your specific situation for the best advice.