General & Vascular Surgery

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Gastroenterology & Internal Medicine

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SURGERY PRE-ADMISSION INSTRUCTIONS

Patient Education Surgical Site Infections

What is a Surgical Site Infection (SSI)?

A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. Most patients who have surgery do not develop an infection. Some of the common symptoms of a surgical site infection are:

  • Redness and pain around the area where you had surgery
  • Drainage of cloudy fluid from your surgical wound
  • Fever

Can SSI’s be treated?

Yes. Most surgical site infections can be treated with antibiotics. The antibiotic given to you depends on the bacteria (germs) causing the infection. Sometimes patients with SSIs also need another surgery to treat the infection.

What can be done to prevent SSI?

To prevent SSI’s doctors, nurses and other health care providers:

  • Clean their hands and arms up to the elbows with an antiseptic agent just before the surgery.
  • Clean their hands with soap and water or an alcohol-based hand rub before and after caring for each
    patient.
  • May remove hair immediately before your surgery using electric clippers (not a razor) if the hair is in
    the same area where the procedure will occur.
  • Wear special hair covers, masks, gowns, and gloves during surgery to keep surgery area clean.
  • Give you antibiotics before surgery starts. In most cases, you should get antibiotics within 60
    minutes before the surgery starts and the antibiotics should be stopped within 24 hours after surgery.

What can you do to help prevent an SSI?

To prevent SSI’s doctors, nurses and other health care providers:

  • Clean their hands and arms up to the elbows with an antiseptic agent just before the surgery.
  • Clean their hands with soap and water or an alcohol-based hand rub before and after caring for each
    patient.
  • May remove hair immediately before your surgery using electric clippers (not a razor) if the hair is in
    the same area where the procedure will occur.
  • Wear special hair covers, masks, gowns, and gloves during surgery to keep surgery area clean.
  • Give you antibiotics before surgery starts. In most cases, you should get antibiotics within 60
    minutes before the surgery starts and the antibiotics should be stopped within 24 hours after surgery.

After your surgery:

  • Make sure that your health care providers clean their hands before examining you either with soap and water or an alcohol-based hand rub. If you do not see your health care providers clean their hands, please ask them to do so.
  • Family and friends who visit you should not touch the surgical wound or dressings. Family and friends should clean their hands with soap and water or an alcohol based hand rub before and after visiting you. If you do not see them clean their hands, ask them to clean their hands.

What should you do when you go home?

Before you go home, your doctor or nurse will explain everything you need to know about taking care of your wound. Make sure you understand how to care for your wound before you leave the hospital.

  • Always clean your hands before and after caring for your wound.
  • If you have any symptoms of an infection, such as redness and pain at the surgery site, drainage, or
    fever, call your doctor immediately.
  • If you have additional questions, please ask your doctor or nurse.

COLONOSCOPY

AFTER CAREFUL CONSIDERATION, YOUR DOCTOR ADVISES AN EXAMINATION CALLED A COLONOSCOPY.

PLEASE COME TO THE EMERGENCY ROOM REGISTRATION LOCATED IN THE FRONT OF THE HOSPITAL TO THE LEFT OF THE MAIN ENTRANCE. YOU WILL REGISTER THERE. IF YOU NEED ASSISTANCE A PHONE IS LOCATED IN THE LOBBY LABELED SURGERY PATIENTS REGISTRATION.

INSTRUCTIONS:

  1. A clear liquid diet is required for twenty-four (24) hours prior to your procedure. (Clear liquids include broth, tea, black coffee, jello, ginger ale, apple juice, popsicles, etc.)
  2. At 6:00 PM, drink 8 oz. of the Golytly every 15 minutes until gone.
  3. You must not have anything to eat or drink after midnight the day before your procedure.
  4. If you are on a blood pressure or heart medication that you usually take in the morning,
    you may do so with a small sip of water.
  5. It takes approximately thirty (30) minutes for your physician to perform your procedure.
    Then you will go to the recovery room for at least thirty (30) minutes.
  6. The sedation you will receive during the procedure will make you drowsy. Plan to take the
    rest of the day off from school or work.
  7. Someone must be present to drive you home.
  8. Please bring a current medication list with you.

WHAT IS A COLONOSCOPY?

A colonoscope is a long flexible tube that is about the thickness of a finger. It is inserted through the rectum, into the large intestine (colon) to carefully examine the lining of the colon. If something is suspicious or an inflammation is seen and needs to be examined in more detail, your doctor can pass an instrument through the colonoscope and take a small piece of tissue (biopsy) for examination in the lab. Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected. A small brush can also be introduced as well to collect cells from an area for laboratory examination.

WHAT IS A POLYPECTOMY?

During the course of the examination, a polyp may be found. Polyps are abnormal growth of tissue, which vary in size from a tiny dot to several inches. If one or many polyps are found, a wire loop (snare) can be passed and an electrical current is used to sever the attached polyp. You should feel no pain during the removal of the polyp. Polyps are removed because they can cause bleeding and may contain cancer cells. Although the majority of polyps are benign, (non-cancerous), a small percentage may contain an area of cancer or may develop into cancer. Removal of polyps, therefore, is an important means of preventing and curing colon cancer, which is one of the leading forms of cancer in the United States.

WHY IS COLONOSCOPY NECESSARY?

Colonoscopy is a valuable tool for diagnosis and treatment of many diseases of the large intestine. Abnormalities suspected by X-ray can be confirmed and studied in detail. Even when X-rays are negative, the cause of symptoms such as rectal bleeding or change in bowel habits may be found by colonoscopy. It is useful in the diagnosis and follow-up of patients with inflammatory bowel disease as well.
Colonoscopy’s greatest impact is probably in its contribution to the control of colon cancer by polyp removal. Before colonoscopy became available, major abdominal surgery was the only way to remove colon polyps to determine if they were benign (non-cancerous) or malignant (cancerous). Now polyps can be removed easily and safely without surgery. Periodic colonoscopy is a valuable tool for follow-up of patients with previous polyps, colon cancer or a family history of colon cancer.
Colonoscopy is a safe and extremely worthwhile procedure, which is very well tolerated. There is still a chance that a polyp behind a fold could be missed. If you have questions, do not hesitate to speak to your doctor about it.

WHAT SHOULD YOU EXPECT DURING THE PROCEDURE?

You will receive medication that will make you feel relaxed and sleepy. While lying on your left side, that colonoscope is passed through the rectum and advanced gradually. The procedure is extremely well tolerated and rarely caused pain. Many patients even fall asleep during the procedure. There may be some discomfort during colonoscopy, but is usually mild. In rare cases, passage of the entire colon cannot be achieved, though a limited examination may be sufficient if the area in question was visualized.

WHAT HAPPENS AFTER THE COLONOSCOPY?

You may feel bloated for a few minutes after the procedure because of the air introduced to examine your colon. You will be able to resume your regular diet after the colonoscopy unless your doctor instructs you otherwise.

ARE THERE COMPLICATIONS FROM COLONOSCOPY AND POLYPECTOMY?

Colonoscopy and polypectomy are safe and associated with very low risk when performed by physicians trained in Endoscopy. One possible complication is perforation, in which a tear through the wall of the bowel may allow leakage of intestinal fluids. This complication usually requires surgery, but may be managed with antibiotics and IV fluids in selected cases. Bleeding may occur from the biopsy or polyp site. It is usually minor and stops on its own or can be controlled by cauterization (application of electrical current) through the colonoscope. Rarely transfusions or surgery may be required.
Local irritation of the vein may occur at the site of medication injection. A tender lump may develop, which may remain for several weeks to several months, but goes away eventually. Other risks include drug reactions and complications from unrelated diseases, such as heart attack or stroke. Death is extremely rare, but remains a remote possibility.

WHAT HAPPENS AFTER THE COLONOSCOPY?

You may feel bloated for a few minutes after the procedure because of the air introduced to examine your colon. You will be able to resume your regular diet after the colonoscopy unless your doctor instructs you otherwise.

IF YOU HAVE ANY QUESTIONS OR ARE UNABLE TO KEEP YOUR APPOINTMENT, PLEASE CALL 865-213-8590.