• What is the problem?
  
  
• What does the operation consist of?
  
  
• What happens before the operation?
  
  
• What happens after the operation?
  
  
• General advice

WHAT IS THE PROBLEM?

You have a lump or a mark or a blemish which is causing trouble or worry. There are three good reasons for having the piece taken out. First you will be freed from the symptoms. Second, it will no longer be there to worry you. Third, we can examine the piece under a microscope to find out exactly what it is.

WHAT DOES THE OPERATION CONSIST OF?

The piece is cut out using an incision which is planned to leave the best possible scar afterwards. Whenever possible this means using natural skin lines and creases. The wound is closed usually with stitches.

WHAT HAPPENS BEFORE THE OPERATION?

Reception

When registering at reception your medical aid details will be required. Your medical aid may require that you obtain an authority number from them for the hospital. Please check this. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission.

Welcome to the ward

You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses.

Visit by the anaesthetist

If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had.

Diet

You will have your usual diet until 6 hours before the operation when you will be asked to take nothing by mouth. This will let your stomach empty to prevent vomiting during the operation.

Shaving

The operation area will be shaved to remove excess hair.

Timing of the operation

The timing of your operation is usually arranged the day before so that the nurses will tell you when to expect to go to the operating theatre. Do not be surprised, however, if there are changes to the exact timing.

Transfer to theatre

You will be taken on a trolley to the operating suite by the staff. You will be wearing a cotton gown, wedding rings will be fastened with tape and removable dentures will be left on the ward. There will be several checks on your details on the way to the operating theatre where your anaesthetic will begin.

The operation is then performed.

WHAT HAPPENS AFTER THE OPERATION?

Coming round after the anaesthetic

Although you will be conscious a minute or two after the operation ends, you are unlikely to remember anything until you are back in your bed on the ward. Some patients feel a bit sick for up to 24 hours after operation, but this passes off. You will be given some treatment for sickness if necessary.

You will be taken on a trolley back to your bed.

If you have had only a local anaesthetic you will be completely awake and alert throughout.

Will it hurt?

Local anaesthetic will wear off after an hour or two, so the wound gradually gets uncomfortable. Take Aspirin or Paracetamol early to control any pain. Feeling in the wound may come back quicker after a general anaesthetic so that you should be ready to take painkillers inside an hour.

The wound should be just about painfree within a day or so.

Drinking and eating

You can drink and eat normally straight away after a local anaesthetic, unless the wound is on your lip or in your mouth, when you should wait until the feeling has come back.

You can drink within 2 hours of a general anaesthetic and eat normally within 12 hours.

The wound and stitches

The wound may have stitches which need to be removed or stitches which melt away. There may be a dressing or no dressing. You will be told about the arrangements for your own wound.

There may be some purple bruising around the wound which spreads downwards by gravity and fades to a yellow colour after 2 to 3 days. It is not important.

There may be some swelling of the surrounding skin which also improves in 2 to 3 days.

Washing

You can wash the wound area as soon as the dressing has been removed. Soap and warm tap water are entirely adequate. Salted water is not necessary. You can shower or bathe as often as you want.

How long in hospital?

You can USUALLY leave the hospital the same day after a stay of a few hours. Occasionally it may be necessary to stay overnight. Please make sure that arrangements to see the surgeon for a followup visit about one week after your operation have been made.

Sick notes

Please ask the surgeon for sick leave forms or certificates which may be necessary.

After you leave hospital

You should feel quite normal after leaving hospital. Some people feel a little sickly for a day or so after a general anaesthetic. This passes off.

Driving

After a local aneasthetic you can drive straight away. After a general anaesthetic you should wait 24 hours before driving.

Work

You should be able to go back to work within 24 hours. Occasionally a day or two off work may be recommended.

Complications

Complications are unusual but are rapidly recognised and dealt with by the nursing and surgical staff. If you think that all is not well, please ask the nurses or doctors.

Bleeding may show up as swelling under the skin or by blood coming through the dressing. This may happen in the first 12 hours. Get advice from your doctor straight away.

Wound infection is sometimes seen and will be treated appropriately.

The wound is not strong enough to take blows or rough treatment for 2 to 3 weeks. Be careful with it during this time.

Occasionally there are numb patches in the skin around the wound which get better after 2 to 3 months. The wound may take up to a year to really soften and fade. Rarely there is thickening in the wound that lasts longer.

GENERAL ADVICE

The operation is a minor one and the results are very good.

If you have any problems or queries, please ask the nurses or doctors.