Surgical Instructions

General Pre-Surgery Instructions

Do not eat or drink anything after MIDNIGHT the night before your surgery.
Identify and bring with you a person who will bring you home following surgery. You will not be able to drive yourself home.
If you need a work or school excuse, please obtain one at your office visit, or call or visit our office and provide a number where we can fax the form to you before surgery.
If you have disability forms that must be completed, contact Cindy at 314-909-1359, ext. 104 to arrange for their completion. There is a $5 per page fee to complete these forms. Family Medical Leave Act (FMLA) forms are completed at no charge. NOTE: Do NOT bring disability or FMLA forms with you to your surgery.

Outpatient surgery

Any pre-operative testing should be completed as soon as possible before your surgery so the results can be processed and sent to us prior to your procedure. If tests aren’t completed in a timely manner, we reserve the right to reschedule or cancel your surgery.
Any required pre-testing should be coordinated with your primary care physician, lab or local hospital.
If you have a major medical condition or any orthopedic complications, please advise Dr. Collard as soon as possible, as you may require additional testing prior to surgery.
If you are seeing a cardiologist for any reason, we must have clearance, in writing, before we can perform surgery. Clearance should be faxed to 314-984-9861.

Pre-Operative Testing

For in-patient surgery, all pre-testing must be done in advance, preferably at least two weeks before your scheduled surgery.
Pre-testing typically includes a chest x-ray, an EKG and blood work.
Medical clearances are required for all major medical conditions at least one week before surgery. Please contact your physician’s office in advance of this one-week timetable.

Medications

Stop taking any anti-inflammatory medications (e.g., Advil, Ibuprofen, Motrin, Aleve, Naprosyn, and Aspirin) at least five days before your scheduled surgery.
You are permitted to take pain relievers that are not considered anti-inflammatories. These include Tylenol, Mobic and Celebrex.
If you take Plavix or Coumadin/Warfarin, contact your primary care physician to discuss temporarily discontinuing their use. Generally, you should stop taking these medications five days prior to surgery.
Please bring a list of current medications with you to the hospital or surgery center.
If you use an inhaler for asthma, please bring your medicine with you to surgery.

Attire

Wear simple, loose-fitting clothing that will be comfortable following surgery. Your clothing should be able to accommodate a large dressing at the surgical site.

When to arrive

A nurse from the hospital or surgery center will call one or two days prior to your surgery with your arrival time.

Prescriptions following surgery

The Corner Pharmacy will deliver your pain medication and antibiotic prescriptions to the outpatient surgery center at the time of your surgery; all other prescriptions can be filled at the hospital. Please have any co-payments ready for collection at that time.

General Post-Operative Surgery Instructions

The following post-operative instructions provide general guidelines for orthopedic surgery. If you have specific questions or concerns, please call our office at 314-909-1359.

Pain Medication

If you have been given a prescription for pain medication such as Percocet or Vicodin, keep in mind that these are narcotic medications. One to two pills can be taken every four to six hours. Nausea and stomach pain sometimes occur with these medications, so avoid taking them on an empty stomach. Drowsiness, constipation and difficulty concentrating are also common side effects. You must not drive, drink alcohol, make critical decisions, sign important documents or do any type of activity requiring concentration or alertness while taking these medications. If you become constipated, contact your local pharmacy for an over-the-counter stool softener. You are not required to take pain medication; it is available if you need it.

Dressing

Keep the dressing clean and dry for two to three days after surgery. You may then remove the dressing and shower, being careful to prevent water from hitting your incision area directly. After showering, you may cover your incision either with Band-Aids or a new dressing.
To minimize swelling, replace the Ace wrap during the day. If your dressing becomes saturated or soiled before the third day after surgery, you may change it using sterile gauze and wiping the wound with alcohol or betadine.
A small amount of blood or drainage on the dressing is not unusual in the first few days. If drainage is excessive or bright red blood appears, please call our office for instructions. Bruising is common after surgery. It is caused by bleeding into the soft tissue and will resolve on its own.
If TED hose is part of your dressing, please leave it on for the first three days following surgery before removing it to shower. Then reapply it until your first post-operative visit.

Blood Clots

Unless you are allergic to aspirin, take one per day the first week following surgery. Aspirin helps decrease the stickiness of the platelets in the blood stream and minimizes the chance of blood clots. In addition, pump your ankle up and down frequently to stretch and contract the calf muscle. This exercise helps to keep blood flowing in your veins when your activity level is low.
Please notify our office if you have severe pain and swelling in the back of your calf. If you have been given TED hose, please wear it as directed until your first post-operative appointment with Dr. Collard.

Crutches

You may need crutches following surgery. Please use them if they are ordered. Crutches can be rented at most Walgreens and other pharmacies. You will likely be required to pay a deposit, which is returned to you when you return the crutches.
In most cases, you will be allowed to put your full weight on your leg after surgery. If your muscles are weak, you may be at risk of falling. As your leg becomes stronger (usually within 10 to 14 days) you may wean yourself off the crutches.

Activity

Rest as much as possible for the first two to three days following surgery. Keep your leg or other affected body part higher than your heart to minimize swelling and pain. Use an ice pack as needed for pain. Place a washcloth between the ice pack and your skin; never place it directly on your skin. Intermittent swelling is normal in your knees, lower leg and foot. If this occurs, apply an Ace wrap and ice pack, and keep the extremity elevated above the level of your heart.

Diet

Begin with small amounts of clear liquids. Gradually resume your normal diet as it becomes tolerable. Keep in mind that nausea is common after surgery due to the anesthetic and pain prescriptions. If nausea continues, please notify our office, and we may be able to call in a prescription to make you more comfortable.

Warning Signs

Please observe the skin color, temperature and sensation of the affected extremity every hour while awake. Always compare it with the unaffected extremity. Notify Dr. Collard’s office if you observe pale or blue nail beds, or cold or numb toes.
Please also call the office immediately if you develop:

Persistent vomiting
Inability to urinate
Persistent high fever (over 101.5 degrees Fahrenheit
Persistent chills, sweats or shaking episodes
Numbness in the extremity
Foul smelling drainage on your dressing or discoloration in the extremity

Appointments

Please call our office at 314-909-1359 after surgery to schedule a post-op appointment. Schedule your appointment for two weeks after surgery, or as instructed by Dr. Collard.

Arthroscopy Post-operative Instructions

Keep your leg elevated above heart-level to minimize swelling.
The dressing at the site of surgery is sterile. Keep it clean and dry for three days before removing it. You may then shower. But do not soak your leg in water.
Use crutches, if ordered. In most cases, you will be allowed to put your full weight on your leg after surgery. Your muscles, however, may be weak, creating a fall risk. As your leg becomes stronger (usually over 10 to 14 days), you may wean yourself off the crutches.
Use an ice pack as much as possible to reduce pain and swelling. Place a wash cloth between the bag of ice and your skin. Never place an ice pack directly on your skin.
To alleviate discomfort following your operation, you will be given pain medication. Do not take this medication on an empty stomach.
Expect to see blood-tinged drainage on your dressing. If the drainage is excessive or contains bright red blood, notify your doctor.
Occasional swelling is normal in your knees, lower leg and foot for several weeks after surgery. When swelling occurs, apply an icepack and elevate your knee, leg or foot.
Bruising is common following surgery. Caused by bleeding into your soft tissue, it will resolve on its own.
In the first days and weeks following surgery, compare the skin color, temperature and sensation of your affected extremity with that of the unaffected one. If you observe pale or blue nail beds, or cold or numb toes, notify Dr. Collard.