Pre-operative Information
Following your consultation with Dr Shaw, you will be provided with the following:
Location and date of your surgery
A fee estimate, or informed financial consent for your operation
Patient information sheets specific for your operation
Instructions on how to complete hospital admission forms
Pre-operative instructions to be read carefully, especially with regards to usual medications.
Our staff will assist you with:
If you having a sentinel lymph node biopsy for melanoma, you will need a lymphoscintigraphy prior to surgery, our staff will help with the booking and coordinating timing to your operation.
If you have significant medical conditions, you may be referred to the pre-admission clinic for an assessment by the anaesthetic team
For you surgery:
You will usually be notified by the hospital the day before surgery about what times to fast from and what time to arrive at the hospital
Please bring a GP health summary, list of current medications, and any relevant imaging with you on the day of surgery.
If you are staying overnight, please bring toiletries, and loose fitting clothes to wear post-operatively.
Please arrange for a relative or friend to accompany you to the hospital. Even with day surgery with sedation only, you will not be permitted to drive home yourself. You may be drowsy or nauseated from the anaesthetic, or sore from the procedure so taking public transportation, Uber, or taxis is not appropriate.
On the Day of Surgery
Fasting
Follow the instructions from your anaesthetist or the hospital in regards to fasting times. This is commonly from midnight the night before your surgery. Frequently, if your operation is in the afternoon, you will be permitted an early breakfast. Generally 6 hrs is required after having solids before an anaesthetic is safe.
Why? To allow time for your stomach to empty and prevent you from vomiting and aspirating as the anaesthetist puts you to sleep.
Showering
Unless otherwise instructed please shower, cleanse, and wash your hair the morning of surgery as normal. You can brush your teeth but avoid drinking water.
Clothing
We recommend that you wear loose fitting clothing to wear post op. Not your Sunday’s best!
Please avoid
Wearing make-up, jewellery, rings and piercings
Wearing contact lenses (it’s better to wear glasses into theatre and bring contacts for post op is staying in hospital)
Bringing valuables into hospital
Wearing moisturisers, talc or lotions near any areas to operated on
Why? Lotions may limit the action of skin preparation in theatre and increase your risk of bacterial contamination.
Imaging reports
Please bring any relevant imaging packets or reports with you on the day of surgery. This is often needed to confirm the site and side of the pathology to be treated.
Forgetting the imaging may lead to delays in starting your operation.
Transportation
Please arrange for a relative or friend to accompany you to the hospital. Even with day surgery with sedation only, you will not be permitted to drive home yourself. You may be drowsy or nauseated from the anaesthetic, or sore from the procedure so taking public transportation, Uber, or taxis is not ap
Smoking +
We strongly recommend that you stop smoking as soon as possible. This includes the use of nicotine patches and gums.
Why? Smoking increases the risk of lung complications. Nicotine reduces blood flow in the microcirculation of the skin and can interfere with the healing process. This can lead to an increase in post operative complications such as your risk of infection and blood clot formation.
Prescription Medication +
Take your regular medications with a small sip of water in the morning of your surgery. Medications you should continue include:
Heart medication
Blood pressure medications
Anti-acid reflux medications
Steroids and immunosuppressants
Thyroid medication
Anti-seizure medication
Asthma medication
If you are unsure as to which medication you can, or can’t take, please check with your Surgeon or Anaesthetist.
Diabetes Medication +
If you are diabetic, you will need to discuss with your Anaesthetist what medications to take or withhold in the days leading up to surgery
Here are some general recommendations that you may be instructed.
Oral medications:
SGLT2 inhibitors such as Empagliflozin, Dapagliflozin, Canagliflozin should be stopped 3-4 days before surgery. If continued, they can cause a condition called euglycemic diabetic ketoacidosis in type 2 diabetes patients post operatively.
Other oral hypoglycemic medications such as Metformin and Sulfonylureas should be withheld the morning of surgery.
If you are a type 1 Diabetic or type 2 diabetic on insulin, please discuss pre-operative dosing with the anaesthetist.
Here are some rough / general recommendations:
For type 2 diabetes patients on once daily dosing of long acting insulin such as NPH, Glargine, Detemir should reduce their dose on the night before or morning of surgery by 25%.
For patients on twice daily dosing with a long acting insulin (mostly type 1 diabetic patients), you will likely be asked to reduce the morning dose by half, and omit short acting insulin once fasting.
Blood Thinning Medication +
Blood thinning medication may need to be stopped up to a week before surgery to allow for its effect to wear off. It is extremely important to discuss this with your Surgeon, GP and Cardiologist if appropriate.
Some blood thinners such as Aspirin and Plavix (Clopidogrel) work on platelets to prevent them from clumping and forming a clot at the site of injury. Where possible, these need to be stopped 7 days prior to surgery.
Other types of oral blood thinning medication include:
Warfarin, Apixaban (Eliquis), Dabigatran (Pradaxa), Edoxaban (Savaysa), Rivoroxaban (Xarelto). These usually need to be ceased 72hrs prior to surgery.
Other types of injectable blood thinning medication include Heparin and Clexane. Please clarify when to cease these medication depending on the indication for taking them.
Why? Blood thinning medications acting through various mechanisms prolong blood clotting time and can increase the risk of significant intra-operative and post-operative bleeding.
Anti-inflammatory Medication +
We recommend avoiding anti-inflammatory medication for 2 weeks prior to surgery.
These include:
Aspirin, Dyspirin, Nurofen, Ibuprofen, Naproxen, Naprosyn, Voltaren, Celebrex
Why? Anti-inflammatories can prolong blood clotting and increase your risk of intra- and post-operative bleeding.
If you require some pain relief for headaches, aches or pains, we recommend taking Paracetamol in the first instance.
Herbal Supplements +
Please stop taking herbal supplements and herbal teas 2 weeks before and after your surgery.
These include those supplements containing Vitamin E, Fish oils, Ginseng, Green Tea, St John Wort, Turmeric, Ginger and Garlic pills amongst others.
Why? Herbal extracts can increase the risk of bleeding by inhibiting blood clotting factors, affect blood pressure, and/or interfere with your anaesthesia