Before Surgery:
- Please contact the pre-admission clinic for a general health check.
- You will be given a form for routine pre-operative bloods and a skin/nose swab.
- Purchase an Antiseptic liquid Body Wash (Microshield 2 Chlorhexidine Skin Cleanser and use as a body wash in the shower for 2 days prior and the morning of surgery.
- Cease all blood thinning medication warfarin, aspirin, plavix, fish oil, glucasamine and herbal medication as advised. If you are on long term blood thinning medication. I will liase with your cardiologist / GP about the timing as to when to cease these medications and if you need alternative cover.
- Diabetic Medication: You need to cease the following medication 3 days before surgery: Jardiance, Jardiamet, Forxiga, Quern, Glyxambi, Xigduo XR, Stelatro, Segiuromet, Steglujan, Invokana
- If you are due to have dental work, routine colonoscopy or prostate procedures, please have this done at least 4 weeks prior to your hip surgery.
- Blood Iron and Vit D Level: It has been shown that having normal iron levels and vitamin D levels will result in reduced complications. Your blood tests prior to surgery will test for these levels and if they are low, you will need to take a supplement.
- Smoking should be stopped or reduced significantly prior to surgery as smoking has been shown to be associated with increased complications.
- Skin/Nasal swab. As a routine I test for skin organisms. We all carry organisms on our skin. The bodywash pre op is to reduce the skin organism count. Occasionally the pre-op test will pick up a methicillin sensitive staph or a methicillin resistant staph. The DOES NOT mean you are infected but rather these bugs are on the skin. It may mean the hospital will take extra precautions with nursing care. You will be prescribed an ointment for 48 hrs to use in your nose (mupericin) to decolinise the nares.
The Surgery:
- Admission is on the day of Surgery.
- The Hospital will contact you regarding fasting and admission times.
- You will meet the Anaesthetist and can discuss in detail the modes of anaesthesia and the pain relief protocol with him.
- I have been working with the same Anaesthetic team and nursing team for over23 years and everyone is well skilled in their roles.
- I will always see you prior to surgery (when admitted) and will mark the skin around the hip I am replacing.
- Surgery usually takes about 60-70 min.
- Most patients will have a spinal anaesthetic combined with a light general anaesthetic or light sedation
- A urinary catheter is inserted to prevent you having urinary retention from the spinal. The catheter is removed within 12-24hrs after surgery. The spinal will wear off after about 4-5 hrs and you will regain muscle control but still should have good pain relief
- Local Anaesthetic is injected around the wound providing added pain relief.
- A surgical drain is left in the wound to drain excess blood and the drain is removed 12-24 hrs after surgery.
- Intravenous antibiotics are administered for 24 hrs as a prophylaxis against developing an infection.
- Hip Replacement surgery carries a risk of developing a DVT (Deep Vein Thrombosis Prophylaxis). Patients are given medication to help prevent this complication together with calf compressors and early mobilisation. The type of medication a patient is given will depend on their individual risk profile. The Australian Arthroplasty Society and the Australian Commission on Safety and Quality in Health Care Standards guidelines are used. Aspirin, Xeralto or Clexane, depending on your individual DVT risk profile, is used as a means to reduce DVT. Calf compressors are applied to your legs whilst you rest in bed to prevent the formation of a DVT.
- Please bring loose clothing (like a tracksuit or equivalent) to the hospital. The sooner you dress in normal cloths, the better you will feel.
- Everyone recovers at a different pace. Most patients are ready for discharge after 48-72 hrs but I never discharge anyone until they are confident and mobile.
