Every surgery involves a great deal of planning and preparation. Much of this work goes on ‘behind-the-scenes’ and involves a very large team of people, all of whom are working hard to ensure that you receive the very highest standard of care and acheive the very best possible outcome from your treatment.
In terms of your own preparations, in addition to ensuring that we have a complete medical history, and all other information neccessary to complete your procedure safely, there are a number of things that you must do.
You will need to prepare your skin in advance of surgery using an over-the-counter antibacterial solution like Phisohex, Chlorhexidine or Triclosan. You should begin using this two to three days prior to your surgery and continue to use it during your post-operative phase, except in the case of an allergic reaction.
The night before your surgery, you will be required to wash with the sponge provided in your pre-admission clinic. It may be neccessary to complete a skin test, if you suspect an allergic reaction.
You must notify us immediately if you feel unwell or develop a cold or fever in the 7 days prior to your surgery.
Depending on your procedure, it may be neccessary to to complete bowel preparation in advance.
This typically involves following a restricted diet in the days leading up to your surgery, combined with medication to ensure that your bowels are empty before your procedure.
You will be able to discuss any preparation with your care team.
Certain substances can pose a risk of harm when you’re having surgery, and so we generally advise that you refrain from taking them in the days and weeks leading up to your procedure. The following schedule provides a general guide to how you should manage your intake of these substances.
30 days before surgery: halt any supplements designed to support heart and joint health can cause blood thinning and increase bleeding. These include krill oil, fish oil, green lip mussel extract and glucosamine. If you are taking other substances for the same purpose, please consult with Prof. Al Muderis or a member of his team.
We recommend that, if you are not already doing so, you begin to supplement with Vitamin D, Magnesium, Calcium and Vitamin C at least 30 days prior to your surgery to support your wellbeing during surgery and rehabilitation.
10 days before surgery: halt any medications, or naturopathic and herbal suppolements, designed to reduce inflammation. These include Nurofen, Voltaren, Celebrex and ibuprofen. If you are taking any other substance for the same purpose, please consult with Prof. Al Muderis or a member of his team.
Halt blood thinners such as Warfarin, Clopidogrel, and Aspirin. It is important that you inform your prescribing doctor that you are intending to halt your prescription to allow your care to be managed.
You may continue to use Panadol.
2 days before surgery: halt any SGLT2i agents, including apagliflozin (Forxiga) and empagliflozin (Jardiance), and any medications containing metformin (Xigduo, Jardiamet).
Smoking and vaping: if you smoke or vape, we strongly advise that you quit prior to your surgery. Smoking compromises blood flow, which reduces the rate at which oxygen and vital nutrients reach your surgical site, slowing the healing process and significantly compromising your recovery.
Drinking alcohol: alcohol use can result in impaired blood flow and delayed wound healing. It can also increase bleeding and interfere with anaesthesia and pain management. If you drink alcohol, it is important that you halt your intake at least two days prior to your surgery.
Controlled substances: narcotic use is associated with delayed wound healing and an increased risk of post-operative complications. It can also interact with your pain medication and anaesthesia. You must inform the care team if you use any substances.
If you are planning to have dental work completed, including fillings, extraction or cleaning, you must ensure that it is completed well in advance of your surgery. For major work, this should be 2-4 weeks before your procedure date; for minor work, 1-2 weeks. In some cases, it may be neccessary to prescribe antibiotics in advance of surgery to reduce the risk of infection associated with dental work.
Exercising prior to your procedure can often help to improve your recovery. You can ask your care provider for pre-surgical exercises which will help strengthen the muscles around your surgical site, or those which aid in walking, for example. Additional exercises will be prescribed following your surgery, to optimise your recovery.
Leading up to your procedure, you should avoid any activities that may result in injury, e.g., gardening. Even minor cuts in the area of your surgical site may prevent the surgery from taking place, given the associated risk of infection.
As part of your pre-surgical preparations, you may be required to complete blood and urine tests, and to complete an echocardiogram (ECG) and/or chest X-ray. Any neccessary tests will be arranged for you by your care team. You should ensure that you bring any existing X-rays and scans with you when you are admitted to the hospital.
Depending on the nature of your procedure, you may be given pre-operative and post-operative exercises to complete and fitted with mobility aids to support your recovery.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
Need an urgent appointment? No problem.
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Professor Dr Munjed Al Muderis is an orthopaedic surgeon specialising in osseointegration, hip, knee and trauma surgery. He is a clinical professor at Macquarie University and The Australian School Of Advanced Medicine, a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group.