Getting ready for surgery: checklist and wound infection prevention

Surgery can feel daunting, but there is a lot you can do to prepare. This article explains what surgery involves, what to tell your care team, how to get your body ready and how to lower the chance of a wound infection. It uses information from MedlinePlus, the US Centers for Disease Control and Prevention (CDC) and the NHS.

1. Introduction

MedlinePlus explains that an operation can relieve or prevent pain, reduce a symptom or improve how the body works. Some operations find a problem, such as a biopsy that removes tissue to be looked at under a microscope, and some, such as heart surgery, can save a life ^[4]. In laparoscopic (keyhole) surgery, operations that once needed large cuts can often be done through much smaller ones, with a thin tube with a camera to see inside the body ^[4].

All surgery has risks. MedlinePlus lists infection, heavy bleeding, a reaction to anaesthesia and accidental injury, and notes that there is almost always some pain after an operation ^[4]. MedlinePlus says keeping diabetes and other conditions under control before surgery lowers the risk of complications ^[1].

2. What to tell your care team

MedlinePlus says to tell your surgeon about ^[1]:

• Reactions or allergies to medicines, foods, skin tapes, adhesives, iodine or other skin cleansers, or latex
• How much alcohol you drink and any use of illegal drugs
• Past problems with surgery or anaesthesia
• Blood clots or bleeding problems
• Recent dental infections or dental surgery
• Smoking or tobacco use
• All medicines, including supplements and herbs bought without a prescription

The NHS gives a similar list for general anaesthetic and also suggests telling staff about any worries, such as fear of needles ^[3]. Keep a current list of everything you take, with amounts and how often, and bring it to every appointment ^[1].

3. Getting your body ready

MedlinePlus suggests these steps ^[1]:

• Pre-operative check-up. Your surgeon will say if you need an assessment, usually a few weeks before surgery. You may need to see a specialist for conditions such as diabetes, lung disease or heart disease. Most hospitals also arrange a visit or call with an anaesthesia provider, and you may need a chest X-ray, lab tests or an ECG (a heart tracing).
• Long-term conditions. Keeping diabetes and other conditions under control lowers the risk of complications.
• Medicines. Some medicines that raise bleeding risk may need to be changed before surgery, usually about two weeks before. Tell all your providers that you are having surgery, because they may suggest changes to your medicines. Ask your surgeon which medicines to take on the day, and check with your team before you change any medicine.
• Dental work. Have it done before surgery, because for some operations, such as joint replacement or heart valve surgery, dental work may need to wait about 3 months afterwards.
• Smoking. Stop smoking if you smoke, because smoking slows healing, and your provider can help.

The NHS adds that staying as active as you can helps recovery, and that you may be asked to stop eating and drinking for a few hours before an anaesthetic, to use a disinfecting shower gel, and to remove jewellery, piercings and nail varnish ^[3].

4. If you become unwell before surgery

MedlinePlus advises contacting your surgeon right away if you develop a cold, flu, fever, herpes outbreak, COVID-19 or another illness in the days before surgery. Your operation may need to be moved to a later date ^[1].

5. Surgical site infection

The CDC explains that a surgical site infection (SSI) is an infection in the part of the body where the operation took place. It can affect the skin, tissue, organs or implanted material such as a hip replacement ^[2]. Signs include redness and pain around the surgical area, cloudy fluid draining from the wound and fever ^[2].

The CDC names diabetes, obesity and allergies as health problems that could affect surgery and treatment, and says people who smoke get more infections. Shaving the area with a razor can irritate the skin and make infection easier ^[2].

6. How you can help prevent infection

The CDC suggests these steps ^[2]:

• Before surgery: tell your provider about other medical conditions, quit smoking and do not shave the area with a razor.
• On the day: speak up if someone tries to shave the area with a razor, and raise any concerns with your surgeon.
• After surgery: ask providers to clean their hands if you do not see them do so. Family and friends should not touch your wound or dressings, and should clean their hands before and after visiting. Clean your own hands before and after caring for your wound.
• Before leaving hospital: make sure you understand how to care for your wound and who to contact with questions.

Treatment of an infection usually involves antibiotics chosen for the germ causing it, and some people need another operation ^[2]. Your doctor decides what is needed.

7. Recovery at home

Before you leave hospital, make sure you understand how to care for your wound and who to contact with questions ^[2]. The NHS advises having someone with you for at least 24 hours after a general anaesthetic and not driving, drinking alcohol or making important decisions during that time ^[3].

8. When to see a doctor

The CDC advises calling your healthcare provider immediately if you notice redness and pain at the surgery site, drainage from the wound or fever ^[2]. The NHS advises urgent advice from a GP or NHS 111 (in the UK) if you are worried about side effects after an anaesthetic, or they do not improve ^[3]. Contact your surgeon too if you become ill before the operation ^[1].

In an emergency, call your local emergency number (112 in India, 911 in the United States).

9. Conclusion

Preparing for surgery means sharing your health history and medicines, keeping long-term conditions under control, stopping smoking and following the instructions of your team. Understanding how to care for your wound and recognising the early signs of infection helps you get help quickly.