Welcome to the Day Surgery Unit page.
Please use the tabs below to explore more information about your upcoming procedure as a day case surgical patient.
Before you have an operation, a surgeon will explain your injury to you and why you need an operation. They will be able to answer any questions you have about treatment options and what the surgery offered will entail. This consultation may be face to face in clinic, on the day of surgery or via a phone call from the virtual fracture clinic.
Please arrange transport to and from the hospital prior to your operation date. Independent travel is not advised.
For day case procedures you should plan to be in hospital all day, as the operation time will depend on the other cases on the list.
Please note, you will not be allowed to have someone wait with you on the ward/in day surgery.
You must stay ‘Nil By Mouth’ before the surgery. This means that you should not consume any food/sweets (including chewing gum)/mints after midnight the night before. You can drink water unless told not to by the anaesthetist or the ward staff.
Please bring your medication including your painkillers with you, so that it can be taken if needed. Please take your painkillers at 6am and let the nursing staff know if you have further pain whilst waiting for surgery.
You will be told where to attend and the time you should arrive. Day surgery is located on D-level.
Any questions should be directed to: Trauma Co-ordinator (8am-3pm) via the hospital switch board. After 3 pm please request the orthopaedic nurse practitioner oncall.
Pre surgery - Pack a small overnight bag to last 24 hours. If your operation is at the end of the day you may need to stay over night for observation.
- Leave your valuables at home
- On the morning of your operation, have a shower/full wash (keep your cast dry if you have one). Do not apply make-up as you will be asked to remove it
- Loose fitting day clothes to wear during your stay: shorts/skirts/tracksuit bottoms, underwear
- Shoes: trainers/slip on shoes which are easy to remove, slippers to walk to theatre in if you prefer
- Nightwear: lightweight dressing gown, pyjamas/ nightdress
- Washbag containing toiletries and soap
- Entertainment/Books/magazines/Music/phone charger
- Regular medication
- Contact details of the person who will be accompanying you home
What happens when I come in to hospital?
You should report to either the Day Surgical Unit or the ward which you have been allocated. The necessary paperwork will be completed here – this will include checking that you have followed the instructions regarding not eating or drinking and medication advice.
Before your operation, you will have you heart rate, blood pressure and temperature checked. Your Consultant/ Surgeon and Anaesthetist will see you, consent you for the operation and answer any questions about the procedure or the day. They will draw an arrow on the skin to ensure the correct side is operated on. Do not wash off this arrow.
Nursing staff will advise you about eating and drinking and let you know an approximate time you will go for your operation. When it is time for your surgery you will be asked to change into a surgical gown and you will be escorted to theatre by theatre staff.
Patient Consent
Before you have an operation or anaesthetic, one of the team caring for you will explain the risks, the benefits and alternatives and a doctor will ask you to sign a consent form. They will make sure you understand what you are consenting to and why it is necessary before you sign. Please ask for an interpreter if you need one or ask for time to discuss you decision with your family.
You can always refuse treatment, even if you have signed the consent form and you can change your mind. You can withdraw your consent at any time. This does not affect your right to alternative forms of treatment, if available.Emergency Operation List ORDER
The daily emergency operating list is not fixed. It is amended hourly based on the priority of life or limb threatening injuries admitted through A&E. You will not be given a fixed operating time and may have a long wait. For day surgical patients, you will be expected to attend for your operation at 7am (unless informed otherwise) and leave the same day. If your operation is cancelled due to an emergency it will be rescheduled.
If you are experiencing pain whilst waiting for your surgery, please inform the staff on the ward. They will be able to liaise with the anaesthetic/surgical team with regards to your pain relief.
You will meet your anaesthetist before your operation. They will ask you questions about your health, previous anaesthetics and usual medicine. They may need to examine your chest with a stethoscope and examine your neck and mouth. Please ask questions and tell them of any worries you may have. The anaesthetist will explain the anaesthetic options for your procedure. They may discuss General, Spinal, Blocks and Local anaesthesia with you.
General Anaesthesia
A general anaesthetic mean that you will be asleep throughout the procedure and therefore will not feel any pain and will have no recollection of the operation itself. You will remember going to sleep and waking up in recovery after the surgery has taken place.
Local Anaesthesia
Local anaesthetics are drugs that have a localised numbing effect. You will feel no pain but you will be able to feel pressure. You will be awake throughout the procedure and able to chat with the theatre staff.Spinal Anaesthetic
Local anaesthetic is injected near the nerves in your back. This makes you go numb from the waist to the feet. You will not feel pain but will remain awake and able to chat to the theatre staff unless you request for a sedative to help you fall asleep naturally. With sedatives you are likely to have little memory of your time in theatre due to falling asleep.
Nerve Block
This is an injection of local anaesthetic near to the nerves that supply that area. You should feel numb and pain-free for up to 48 hours afterwards. You may also not be able to move the affected limb properly during this time. The block may be performed in combination with other anaesthetic types.
You should not smoke prior to having an anaesthetic.
Pain following an operation is inevitable. Different operations lead to varying degrees of post-operative discomfort and everyone experiences pain differently. We aim for your pain to be at an acceptable level on movement and should not prevent any physiotherapy, mobilisation or general function.
Pain control is an essential part of your care
How can we reduce your pain?
Pain relief is available in different forms and strengths. There are doctors and nurses on your ward who can help you with your pain and it is important to let someone know if the pain relief is wearing off and you are feeling uncomfortable.
Side Effects
With all drugs there are some side effects; these may include nausea and vomiting, constipation, headache, dizziness, feeling sleepy and sometimes mild confusion. These side effects can be treated by the ward staff so please let them know.
Allergies
It is vital that you tell the nurse or doctor if you have any allergies to any medication, if you have experienced a stomach ulcer or similar problems from pain relief in the past or if you in are on any pain relief already. This information will help identify the most suitable type of pain relief for you.
Discharge medication ‘To Take Out’ (TTO’s)
You may be prescribed painkillers to take home with you. Always continue pain relief as required, take them as directed and do not exceed the stated dose. Further supplies can be obtained from your GP or local pharmacy.
At Portsmouth Hospitals, we take the prevention of infection very seriously. We have a good record in controlling and reducing the number of healthcare associated infections such as MRSA and C. Difficile. Whilst we have a dedication infection prevention team, we firmly believe that controlling infection is everyone’s business and maintaining a clean and safe hospital environment is a priority for all our staff.
What can you do to help reduce healthcare infections?
If you are a patient
- Please take a shower or bath before coming in for surgery
- Don’t be shy – ask if equipment, such as blood pressure machines or drip stands have been cleaned prior to use on you
- Ask our staff politely if they have cleaned their hands with alcohol gel or soap and water before attending you
- Always wash your hands after going to the toilet and before eating and drinking
- Please use the alcohol hand gel provided at all the main entrances
- Tell a member of staff if you notice dirty areas in the hospital e.g. toilets
- Please tell your nurse or doctor if you have a drip, drain or catheter that becomes sore so that they can change it if necessary
- Please take the whole course of any antibiotic medicine you are given
For visitors
- Please wash your hands or use the alcohol before and after visiting a patient in the hospital
- Not more than 2 visitors at any time around the bed and any children visiting must be supervised at all times so that they do not touch dressings or equipment
- Please check with the nurse in charge before visiting a patient if you have a medical condition that makes you vulnerable to infection
- Lease do not visit a patient if you are unwell yourself or have COVID
- Please do not sit on the bed
You will be given a discharge letter to take home and a second copy will be sent to your GP. You may be given a package containing some spare dressings and painkillers.
If you are prescribed a blood thinning injection, you will receive instructions on how to administer before you are discharged.
You may require a ‘sick certificate’ for work – please let the nurses know on admission and this will be signed on your discharge.
You may be required to have a follow up appointment with your surgeon – a letter containing the date of this will be sent to you in the post.
If you have a general anaesthetic, you will be required to be collected by a responsible adult. General anaesthetics can affect your memory, concentration and reflexes for a day or two, so it's important for a responsible adult to stay with you for at least 24 hours after your operation, if you're allowed to go home. You'll also be advised to avoid driving, drinking alcohol and signing any legal documents for 24 to 48 hours.When you get home
General Wellbeing
It is not unusual to feel tired and your sleep patterns may take a while to return to normal. Remember to keep the affected limb elevated to try and reduce swelling
Your appetite as well as your bowel habits may take a while to recover. Make sure you drink plenty of fluids and try to eat a healthy balanced diet.
Try not to feel frustrated at not being able to do all the things you want straight away. Increase your activity levels gradually. Start with short distances and increase as you feel able.
Controlling pain and discomfort
Take your pain medication as directed. Try not to sit too long in one position during the day. Stand up and have a stroll or change your position in the seat. Ice packs can help soothe the area. Take care not to let your wound get wet and do not leave the ice pack in place for more than 20 minutes at a time. If using ice or frozen peas please wrap it well in a tea towel to ensure you do not burn your skin and check your skin after a few minutes.
TED Stockings
If you have been told to wear your TEDS or ‘Anti-Embolic’ stockings at home, these must be worn day and night following your operation. They should be hand-washed and dried away from direct heat to preserve their beneficial effect.
Medication
Restart all medication as directed on your discharge summary
It is important that you keep your wound and/or plaster cast dry until it is reviewed in clinic or at the GP.
Do not be tempted to remove your plaster cast or dressing as this could lead to infection.
If you have sutures (stiches) or clips these may be taken out in the fracture clinic or by your GP, the nursing staff will advise you on this before you are discharged.
You may feel tingling, numbness or itching as your wound heals. You may also feel a slight pulling around the stitches or staples and a hard lump forming. These are perfectly normal occurrences and are part of the healing process.
Some signs are not normal: if you are concerned that the skin around your wound has become red, sore, hot or swollen, if there is a green or yellow coloured discharge or if you feel generally unwell, feverish or have a temperature, please visit your GP or ring NHS Direct or if feeling unwell go to the Accident and Emergency Department
You should not be driving until it is safe to perform an emergency stop and change gear comfortably. You must inform your insurance company about your operation. It is your responsibility to decide when you are safe to drive again. Your consultant can advise you on this if needed.
This is dependent on the type of operation you have had but may take up to a few months, this may be longer if you have a manual job, your consultant will advise you on this.
You may be required to come back in a few weeks or months following your operation. You will be sent a letter informing you of this in the post.
Who should I contact if I have concerns?
If you have any concerns after the operation it is best to contact the fracture clinic, ward or the orthopaedic nurse practitioners. If it is an emergency please ring 999 or attend the Accident and Emergency Department.
My affected limb is swollen, what should I do?
Swelling after an operation may last for several months. Make sure you keep the limb elevated and move it as much as possible to reduce the swelling
Why is my scar warm?
The healing process creates heat because the body is busy repairing the air. This may continue for up to 6 months and is different to the heat that might be felt with an infection
Is it normal to have disturbed nights?
Yes, few people sleep through the night for the first few days or weeks after the surgery due to finding a new position stiffness and pain.
I have a numb patch around my scar, is this ok?
This is usually due to some of the nerves being disrupted during surgery. The patch should get smaller with time but may not go away altogether.
What should I do with my crutches?
When you have finished with your crutches, please return them to the ‘returned crutches’ bin in the entrance of the orthopaedic clinic or your local NHS physiotherapy department. The crutches are collected and taken away for cleaning and servicing so they can be re-used if appropriate
How should I dispose of my Clexane needles safely?
Please bring your used Clexane needles in the yellow “Sharps Box” you were given and hand them in at your follow-up clinic appointment. Alternatively some pharmacies will accept Sharps and many Councils provide a Clinical Waste Collection Service – you will need to contact your local Council yourself to arrange this.
This charter outlines the level of the care and service you would expect to receive from Portsmouth Hospitals NHS Trust, assisting you with information on your rights. Also included are some expectations our staff and patients have of you.
Your rights: -
- Know how and why you are being treated and what realistic alternatives are available
- Be involved with your care and be given enough information so that you can make informed decisions about your treatment
- Have access to your medical records. There is a procedure which must be followed. Please ask your Ward Sister/ Charge Nurse about this.
- Know the information about your care will not be disclosed to anyone else except the staff who are involved in your treatment
- Choose whether you wish to take part in medical research or medical student training. If you have any concerns about this, please talk to your doctor, ward or clinic nurse.
Your responsibility is to: -
- Ask questions if you do not understand
- Follow the advice or treatment regimens given by Portsmouth Hospitals NHS Trust’s clinical staff and to tell them if you do not intend to follow them
- Sign the appropriate documentation if you discharge yourself against medical advice
- Be honest and open with staff, particularly with regard to you and, where relevant, your family’s medic al history and that medications you are taking. This information will be kept confidential
- Treat with respect other patients, relatives and healthcare professionals equally regardless of differences (colour, gender, religion etc.)
- Seek assistance from the nurse in charge if you feel you are not being consulted with regard to treatment options.
Your feedback is important to us. Portsmouth Hospitals NHS Trust would be grateful if you would complete a questionnaire can be completed either online, via a link on the Portsmouth Hospital NHS trust internet site www.
Comments and Complaints
If you have a comment, concern or complaint about the treatment or care received from Portsmouth Hospital NHS Trust, We want to know and we will do all we can to put it right. All comments and complaints are taken very seriously because we want to learn from the information you give us in order to improve our services. If you are an inpatient or visiting an inpatient please raise your issue with the nurse in charge on the ward or the person in charge of the area. Please be assured if you raise a complaint or make a complaint, comment, or concern your care will not be affected in any way.
Portsmouth Hospitals NHS Trust values everyone’s privacy and dignity and staff are committed to treating you with dignity and respect. Our hospital offers patients same sex accommodation wherever possible. We support patient’s privacy and dignity by:
- Providing well maintained toilets and bathrooms that are cleaned and inspected regularly
- Protecting meal and sleep times where noise and disruption are kept to a minimum
- Keeping patients informed about their treatment and its progress to allow them to make informed decisions about their care
- Being sensitive to individual patient needs as far as possible.
The Data Protection Act 1988 (Caldicott Audit)
Confidential records are kept about you health and the care you receive from the NHS. These records are important; helping to make sure you receive the best possible care from us. The information may also be used to plan NHS services and assist in the teaching and training of health professionals. To make sure that patient confidentiality is maintained a policy has been written informing all staff of their responsibilities.