Going home after surgery

If you have had a day case surgery procedure or an anaesthetic the same day you go home, you will need to arrange your own transport home. This should not be by public passport and you will need to be accompanied by a responsible adult.

If you have stayed in hospital overnight after your surgery, you will be able to travel home on public transport or your own arranged transport. Your surgical team will give you an estimated length of stay before your operation, so you can start making arrangements.

If you require medical transport to get home, the ward team will arrange this for you.

You will be advised if you need to change or stop any of your existing medications following your surgery. If you have started any new medication, you will be given a supply to take home and then this will need to be prescribed by your GP, if it needs to continue.

If needed, you will be given a supply of pain medications to take home and instructions on how to manage any post operative pain. If you need further pain medication you should contact your GP for further advice.

Any changes to your medications will be written on your discharge summary and explained to your before you go home. If you have any concerns or questions, please speak to the nursing or surgical team.

Your surgical team will be able to advise you on how long you will need to stop work while you recover from your operation. This will vary depending on the type of surgery and your medical history.

If you require a sick note, you should discuss this with your surgical team. This will cover you for your inpatient stay plus the first seven days after you discharge. You will need to contact your GP if you require a further sick note.

When you are ready to go home after surgery you will be given a copy of your discharge summary. This will describe the reason for your hospital stay, any treatment or investigations you have had, any changes to your medications and any future appointments you may need. A copy will also be sent to your GP for their records.

If you require any further investigations or follow up appointments with your surgical team, this will be arranged before your discharge. If this is not possible, you will be contacted with the time and date once you are home. Not all operations require a follow up appointment and this will be discussed with you before you go home.

Depending on your operation you may have a surgical wound after you leave hospital. There are different types of wound and it is important to follow the specific advice you are given for your wound.

The below information can help you avoid a wound infection and help with healing.

Dressings

Not all surgical wounds require a dressing. The dressing is there to absorb any leakage from the wound and protect the area until wound healing has begun. It will also help prevent any stitches or clips catching on clothing.

Most dressings should be left in place for at least 48-72 hours (or as advised by your surgical team) after your operation. If the dressing becomes wet from blood or other liquid, it must be changed. If you need to change your dressing you should; wash your hands with soap and water, carefully take the dirty dressing off, not touching the wound with your hands.

After 72 hours most wounds can be left to open air, provided it is not oozing. You will be advised if you need a dressing for longer.

Stitches / Clips / Staples

Most wounds will need stiches (also known as sutures) or clips to help with healing. Some stitches don’t need to be removed as they are dissolvable, however, most will need to be removed between 5 and 21 days. If you see threads (ends of the stiches) poking out of the healing wound, do not pull them.

You will be advised by your surgical team which type of stiches you have. If your stiches need removing this can be arranged with the practice nurse at your GP.

Showering and washing

You are usually able to start washing again 48 hours after your operation. It is best to shower, rather than have a bath, so that your wound is not soaked in water. Your surgeon will advise you if you should wait longer.

Some dressings are waterproof and can withstand being splashed, but should not be submerged under water. You will be advised what type of dressing you have.

You should avoid using any soap, shower gel, ointments, creams or talcum powder on and around your wound site. To dry your wound, you should pat it dry with a clean towel rather than rubbing.

Wound healing

Most wounds heal without any problems. However, wound infections are one of the more common complications after surgery. If a wound becomes infected it may:

• Become more painful
• Leak or weep pus or blood stained fluid
• Smell unpleasant
• Become red, swollen or inflamed
• Cause a fever
• Cause you to feel generally unwell

If you are concerned about your wound or develop a fever you should contact your GP or call NHS 111.

The sooner you start to move around after your operation the better. Lying in bed for too long can cause some of your blood to pool in your legs and this increases the risk of developing blood clots (Deep Vein Thrombosis / DVT).

A DVT can block the flow of blood in the affected vein and can cause pain and swelling in your leg. Sometimes part of the clot can break off and pass through to your lung. This is called a Pulmonary Embolism (PE) and can cause chest pain and shortness of breath. Both of these can be very serious and potentially life threatening.

Other factors can increase your risk of blood clots and include:

• Laying in one position for a long period of time
• Family or personal history of blood clots
• If you have cancer
• Medical conditions such as diabetes or heart failure
• If you are aged over 60

The best way to reduce the risk of blood clots is to start gently moving as soon as you can after your surgery. This can start with sitting out in a chair next to your bed and gentle walking around the ward. Simple leg exercises such as flexing your knees and ankles and rotating your feet help with blood circulation.

At home, it is important to keep moving around as you return to your normal mobility and function. You should also drink plenty of water to keep hydrated and continue the gentle leg exercises.

You may be asked to continue blood thinning injections at home if these were given in hospital. You will be shown how to administer these or a district nurse will be arranged to visit you at home. You should continue to wear your anti-embolism stockings until you are back to your normal mobility.

It is important to continue to be active following your discharge from hospital. You should continue to gradually build up walking and activity levels sensibly. It is important to find the right balance between activity and rest.

Until you are fully recovered, you may find that some household jobs are tiring and cause discomfort. Many people are surprised by the length of time it takes them to recover fully from their surgery. It may be useful to ask for help from relatives or friends for a week or two. Otherwise take steps to reduce the strain such as sitting down to do the ironing or washing up.

You will be told if you need to do specific exercises to help your recovery such as out-patient or community physiotherapy. You will also be told if there are any specific activities or movements you should avoid during your recovery.

It is very important to follow the instructions you are given by your surgical team.

The effects of anaesthetic drugs may last for around 24 hours or longer for major operations. The drugs given during your anaesthetic or sedation can affect your reactions and how you think and make decisions.

Following any general anaesthetic or sedation, you must not drive for at least 24 hours.

It may take longer to recover from your surgery than your anaesthetic. Your surgeon will give you advice on when it should be safe for you to drive after your procedure or operation. If you are taking strong painkillers, you also need to be aware that these drugs can make you feel drowsy and can affect your driving.

Before driving again, you will need to be sure that you can use the brakes, change gear safely and perform an emergency stop.

You need to decide when you can drive safely after surgery. If you feel drowsy, distracted by pain or generally unwell, you’ll need to wait a little longer until it is safe for you to drive.

You should check with your insurance company that you are covered to drive after your surgery. Check with DVLA about any specific time periods recommended – information can be found on the DVLA website.

In most cases, sexual intercourse can be resumed once you have recovered from your operation, your wound is fully healed and you feel comfortable to do so. If your operation is related to this area of the body, you will be given specific advice by your surgical team.

If you have any questions about restarting your usual method of contraception, especially the oral contraceptive pill, please discuss this with your surgical team or GP.

Change in diet, reduced activity and some medication can lead to a change in bowel habit. It is quite normal for your bowels not to open for a few days after an operation but they should return to normal when you are eating normally and fully mobile. Keeping well hydrated is important and will help your bowel function return to normal.

If you have had an operation on your bowels or stomach, your bowel habit may change permanently after surgery. Your surgical team will advise you if this is expected and if you should make any changes to your diet.

If you are not back to your normal bowel habits within two weeks, you should see your GP for further advice.

It is common to feel tired and exhausted after an operation. In addition, it is common to have difficulties in sleeping and even insomnia after surgery.

This is often due to a combination of factors and can include;

• Disturbances to your normal sleeping routine
• Post operative pain
• Medication side effects
• Anxiety about recovery
• Environmental disruption (e.g. medical monitors or equipment and alarms) – especially if you are admitted to ICU or HDU
• Lack of exposure to sunlight

To enhance your post operative sleep, you can take steps to reduce these factors. It is often helpful to consider these before you have your operation. Developing good sleep habits and patterns will help you return to a normal sleep routine quicker after your operation.

Ensuring you have taken appropriate pain medication and have blocked out as much environmental noise and light as possible (using ear plugs and eye mask while in hospital can help) can enhance your sleep quality.

How long sleep disturbances last after surgery depends on the type of operation and anaesthetic and how long you were in hospital for. It will also vary depending on the patient their medical history. Typically, it will last for a few days or weeks. If it persists longer than this you should discuss your symptoms with your GP who may be able to provide further help.