For patients
PATIENT INFORMATION FORM
If you are a new patient, please download and print the Patient information form and bring a completed copy with you to your first appointment with Bernard.
PRE-OPERATIVE INSTRUCTIONS
FASTING
If you are having surgery under sedation or a general anesthetic, you will be given fasting instructions. Generally you will be asked to fast from food and milk products for six hours before surgery. Clear fluids are permissible sometimes for up to 2 hours before surgery. The anesthetist and hospital/day surgery will give strict instructions regarding this. For surgery in the afternoon, usually a light breakfast is permitted.
BLOOD THINNERS
It is important to cease blood thinning medication before surgery if possible. If you have a stent, recent heart surgery/heart attack or a history of deep vein thrombosis this might not be advisable. Please indicate if this is the case. It may be necessary to check with other specialists or your GP.
- Cease taking the following medications 10 days before surgery: Any form of Aspirin, Clopidogrel, Assasantin, Plavix
- Cease taking the following medications 4 days before surgery: Pradaxa, Warfarin
- Cease taking the following medications 48 hours before surgery: Apixaban, Eliquius, Rivroxaban, Xarelto You can normally restart these medications the day after surgery. Please bring your regular medications on the day of surgery for the anesthetist.
POST-OPERATIVE INSTRUCTIONS
DRESSINGS
Sometimes dressings are used in plastic surgery and sometimes wounds are left exposed. There may be a dressing on the sutures (e.g. hyperfix) which can be wet after 24-hours. If the suture line is exposed or if there is a full thickness skin graft exposed you will be asked to wash the wounds daily, gently with soap and water. You can pat the dressings dry or dry with a blow-dryer if you wish. You will be asked to apply an ointment such as Chloromycetin, Vaseline or Pawpaw three times a day to these sutures.
HAND SURGERY DRESSINGS
Following hand surgery, you will be given instructions to elevate the hand in a sling. You will be given instructions on dressings. Commonly, after trigger finger release, dressings can come down after two days and after carpal tunnel release, four days. There will be either Hypafix over the sutures which can stay in place or a mesh dressing (Jelonet) which can be removed and the sutures can then be covered with Hypafix or similar. You will be given instructions on use of the hand which are generally gentle use for activities of daily living around the house. Heavy use of the hand (heavy work and gardening for example) is contraindicated, usually for 6 weeks.
BLEEDING
It is usual to have minor bleeding after plastic surgical procedures. Following skin cancer excision or skin surgery, it is to expected. If there is bleeding, firm compression at 20 minute intervals directly over the source of bleeding and application of ice packs is usually adequate. Elevation is also required. If bleeding cannot be controlled, please contact Dr Carney through his after hours number or the institution where surgery was performed. If unable to contact, please attend your nearest emergency department.
DRIVING POST SURGERY
Following surgery under sedation or general anesthetic you should not drive for 24 hrs. For hand operations or major surgery, it may be advisable to not drive for 2 to 6 weeks. Dr Carney would be more than happy to advise on this.
WOUND CARE
Following simple excisions, flap repair or graft repair of wounds, you will be given post-operative instructions on how to care for your wounds.
Sutures/dressings should be kept dry for 24-hours. If Hyperfix or surgical tapes are applied to the wounds, these can be kept intact for showering and dried by either patting dry or using a blow dryer. If sutures are left open, these can be gently washed daily with soap and water. Routinely, you will be asked to apply either Vaseline, Paw Paw or Chloromycetin ointment to the sutures three times a day. This is especially the case with full thickness skin grafts.
If you are on blood thinners, it is safe to restart them following surgery. If not, Bernard will give instructions.
If bleeding occurs, apply pressure to the area for 10 minutes. If further bleeding occurs after this, another 10 minutes of pressure is indicated. Beyond this, please call the practice. If you are unable to reach Bernard, please contact your GP clinic or attend your nearest emergency department.
Usually there is little discomfort with office-based procedures but as local anaesthetic wears off you may require analgesia. Usually, paracetamol every 6 hours is sufficient. If the wound becomes red and tender, if you are feeling unwell or have a fever, please contact the practice or your general practitioner.
POST-OPERATIVE FOLLOW UP
Following your procedure an appointment will be made for you to see Bernard. This may be in a different location to the initial consultation or via telehealth (video or phone consult). Please check your instructions. If unsure, please call the practice on 1300 774 447.
Office hours are 9.00 am to 5.00 pm Monday to Friday. Outside of these hours, messages can be left and Bernard can be reached by calling 1300 774 447.
If you have problems post-operatively such as ongoing bleeding, pain not controlled by analgesia which has been prescribed for you, ongoing nausea, fevers or sweats, it is imperative that you contact our practice, Dr Carney or present to your general practitioner or nearest emergency Department.
You can download and print the above pre- and post-operative information here.
USEFUL LINKS
Pulse Anaesthetics
Specialist Anaesthetic Services
Stace Anaesthetics
Calvary North Adelaide
Western Hospital