This leaflet contains some useful postoperative information for you and your family or carers to read. This information may not answer all the questions you have, and if this is the case, we encourage you to speak to a member of staff or use the useful numbers section.

Wound healing

Low-adherent dressings or semi-permeable film dressings are applied in theatre and are not removed until 48 hours postoperatively unless concerns are raised about the wound. These wounds usually heal within 8 to 14 days depending on type and site of surgery. This should coincide with the removal of clips or stitches as documented on your discharge letter.

Your operated site may be swollen, painful, bruised and inflamed for a while – these are all common side effects of the surgery you have had. We do however encourage you to be vigilant and tell a member of staff during admission if you feel something is not right or worsening.

Postoperative wound advice

After discharge, should you develop any problems or concerns about your wound please contact the ward you were discharged from first using the contact details in the useful numbers section. We are experts in orthopaedics and wound care and would rather you phone and ask us than go to your GP or worry about your wound at home.

If you experience any of the following possible symptoms of infection, please contact the Wound Infection Helpline directly (see useful numbers section):

• Excessive discharge or ooze from the wound (this may be clear, blood stained or yellow/ green pus)
• Redness or inflammation spreading out from the edge of the wound
• Area around the wound becomes swollen
• The edges of any part of the wound separate or gape open

Clips or stitches

Clips and stitches are usually removed 10-14 days after your operation. Either we will arrange for a district nurse to remove your stitches or clips, or you will be advised to contact your practice nurse to arrange for them to see you. Unfortunately, it is not possible to give you a set time for district nurse calls and sometimes it can be late in the afternoon. If you have any questions or concerns relating to your clips or stitches, consult your discharge letter or contact the ward you were discharged from (see useful numbers section).

Dressings

On discharge depending on the type of wound you have and the aftercare that is required you may be provided with additional dressings. If you have any questions or concerns relating to wound dressings, please contact the ward you were discharged from (see useful numbers section).

Bath or shower

The National Institute for Clinical Excellence (NICE) advises that patients may shower safely 48 hours after surgery. Most dressings we use are shower proof, so having a shower is encouraged. You are advised to use a shower with a non-slip mat for the first few weeks. Please do not have a bath until your wound is completely healed.

Medication

Upon discharge, your medication will be reviewed and written on a discharge form. The pharmacist also needs time to review your discharge form and your medication. This will allow them to make any necessary changes with regards to your medication. The hospital pharmacy team will check that you have enough medication to last you at least 14 days, including any you may have left at home. Any remaining medication of yours will be returned to you along with a supply of any other medication required. Where medication is unobtainable due to manufacturers delay/time restrictions etc, you may need to make arrangements to obtain a further supply from your own GP, to avoid delayed discharge. This will ensure that you have a further supply of the medication required.

When taking your medication, you should follow the instructions printed on the labels. There is a patient information leaflet in each dispensed medicine which will give you more detailed information about the medicines you have been prescribed. If you have any other questions regarding your medicines, please ask a member of staff or contact the pharmacy helpline (see the useful numbers section).

Antibiotics

If you have any infections, you may have been prescribed antibiotics to take home. Antibiotics are given for a specific length of time, and you need to ensure that you complete the course of treatment. You will need to take them at regular specified time intervals to keep the right amount of medicine in your blood stream. If you don’t take your antibiotics according to the instructions given, this can lead to bacteria becoming resistant to them. These bacteria can then become difficult to treat.

There are some antibiotics that you may be discharged on, that require you to have regular blood tests. We will inform you of this if this is required.

Some antibiotics have specific instructions about taking them before, after, or with meals therefore it is important that you read the details on the label.

For more detailed information about the medicine there is an information leaflet    supplied with your antibiotics that you can read. If you have any queries regarding your antibiotics, please contact us using the useful numbers section at the end of this leaflet.

Physiotherapy

Physiotherapy is a very important part of your postoperative treatment and will speed up your recovery. Physiotherapy helps to restore movement to near normal as possible as well as building strength in the muscles around the area where you have had surgery. Physiotherapy treatment can range from:

• Advice and education about your surgery
• Exercises
• Assessing mobility and issuing of walking aids
• Stair assessment
• Hydrotherapy

It is very important that you follow the advice and exercises that you are given by the physiotherapists so that you get the best outcome from your surgery.

Venous Thromboembolism (VTE) or blood clots

You should have received information at preoperative screening or on admission, about the risks of blood clots, the signs, and symptoms and what can be done to help prevent them. It is important that you read this carefully and raise any questions with the doctors or nurses looking after you.

Activities

Avoid heavy housework for the first four weeks after discharge.

Avoid prolonged standing.

Begin gardening gently and do not undertake heavy digging/lifting for several months.

Driving

It will be at your consultant’s discretion as to when you can begin driving again. You will need to let your insurance company know about your operation and be able to perform an emergency stop safely before you can attempt to drive.

Nutrition

Nutrition is an important component after surgery, as it is critical to the recovery process. Eating a varied diet of meat and plant-based sources will provide you with the protein, vitamins and minerals that are important for healing. When choosing meat sources, try to pick lean cuts and prepare products by grilling, poaching, baking, or steaming rather than frying or roasting. Non-meat sources of protein include eggs, milk, yoghurt, lentils, beans, and tofu.

It is important to incorporate variety into your diet. Eating more fruit, vegetables and cereals will boost your vitamin, mineral and fibre intake. 5 portions a day of fruit, vegetables and salads will be highly beneficial as these contain vitamins for wound healing. High fibre food sources, such as wholemeal bread/rice/pasta, Weetabix, porridge and alternative fibre cereals, lentils and beans are great examples to include into your diet for a healthier living and will help prevent constipation.

It is recommended to aim for ¼ of your plate being a protein source (grilled chicken, baked fish, tofu etc), ¼ complex carbohydrate (wholegrain rice, wholemeal bread, wholemeal pasta etc.) and ½ vegetables. In addition to diet, it is important to aim for around 6-8 glasses of fluid per day which can include water, tea, coffee, hot chocolate, milk, squash etc.

If you would like more detailed information in the meantime, please refer to NHS Eat Well at www.nhs.uk/live-well/eat-well/

Returning equipment

You are free to retain any equipment for as long as you need it.

Equipment including crutches and zimmer frames must be returned to the physiotherapy department at ROH, you can bring them with you when you have an outpatient’s appointment.

Contact numbers

After discharge if you have any questions or concerns, please contact the ward you were discharged from (between the hours of 7am and 6pm):

Ward 1 - 0121 685 4282

Ward 2 - 0121 685 4090

Ward 3 - 0121 685 4012

Ward 4 - 0121 685 4112

Ward 12 - 0121 685 4050

Woodlands Suite - 0121 685 4010

ADCU - 0121 685 4080

If you have any concerns out of hours (6pm to 7am) please contact the Clinical Site Coordinator at the Royal Orthopaedic Hospital on 0121 685 4000, asking the switchboard to contact bleep number 2627 and this will put you in touch with a member of nursing staff.

If you have any serious concerns that require immediate attention attend your nearest Emergency Department.

For other concerns not listed within this leaflet, please contact your GP.

Useful Numbers

Main hospital switchboard
0121 685 4000

Outpatients Department
0121 685 4153

Pre-operative assessment clinic (POAC)
0121 685 4035

Discharge liaison sister
0121 685 4000 – ask switchboard to bleep 2684

PALS
0121 685 4128

ROCS
0121 685 4020

Bone Infection Service
0121 685 4000 – ext. 55523

Wound Infection Helpline

The Wound Infection Helpline is to be used if you experience any of the following with your surgical wound:

• Excessive discharge or ooze from the wound (this may be clear, blood stained or yellow/ green pus)
• Redness or inflammation spreading out from the edge of the wound
• Area around the wound becomes swollen
• The edges of any part of the wound separate or gape open

The helpline is available between 8am and 4pm weekdays (Monday to Friday except bank holidays). 

Telephone number: 0121 685 4308

Please note, if you are a University Hospitals Birmingham (UHB) patient you should contact the UHB wound care helpline directly for wound queries and infection concerns.

Do not use the Wound Infection Helplines if you are experiencing any signs or symptoms of Sepsis.  

Please call 111 and report your symptoms to seek the most appropriate help if you are experiencing any of the following:

• feel very unwell or like there's something seriously wrong
• have not passed urine all day
• keep vomiting and cannot keep any food or drink down
• have a very high or low temperature, feel hot or cold to the touch, or excessive shivering

Call 999 or immediately attend your nearest Emergency Department if you experience any of the following:

• acting confused, slurred speech or not making sense
• blue, grey, pale, or blotchy skin, lips, or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing, breathlessness or breathing very fast

Pharmacy

The hospital provides a pharmacy helpline which is open during office hours with an answering machine service available at other times. The following helpline is for any queries you may have relating to your medication.

Tel: 0121 685 4160

If your query is outside office hours and urgent, please contact the Clinical Site Coordinator via the main hospital switchboard.