Indications for prophylactic antibiotics
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Infected foci or an incision nearby
Emergency abdominal surgery
Elective colonic surgery
Upper gastrointestinal operations for malignancy
Vascular surgery
Employing prosthetic implants
Transplantation
Essential step in preoperative
assessment and preparation
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History taking
Physical examination
Collating pre-admission information about diagnosis
Arranging any further diagnostic investigation
Making special preparations for the particular operation
Investigating any intercurrent or occult illness suggested by medical
clerking
Essential step in preoperative
assessment and preparation
• Discussing the operation with the patient and obtaining signed consent
• Marking the operation site
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Making arrangements for the operation with the operating theatre staff
Arranging and informing the anaesthetist
Prescribing medication prophylactic antibiotics etc.
Planning rehabilitation and convalescence
Cardiac failure
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Ischaemic heart disease
Hypertension
Valvular disease
Arrhythmias
Thyrotoxicosis
Severe anaemia
Operation should be postponed until the cardiac failure is
treated and stabilised
Cardiac arrhythmias
Atrial fibrillation
normal pulse rate causes minimal extra risk
uncontrolled fibrillation may cause cardiac failure
Tachycardia
hypotension, sepsis, cardiac failure, fluid overload
Bradycardia
A temporary or permanent cardiac pacemaker
Liver disorder
• Surgery should be avoided unless absolutely essential
• Vitamin K is for prolonged prothrombin time
• Fresh frozen plasma and platelet transfusion is required
Removal of suture
• On the back or around joints 14days
• On the abdomen 7 days
• On the face and neck healing is rapid 3-5 days is safe and giving
a better cosmetic result
Postoperative jaundice
• Prehepatic jaundice : large blood transfusion, absorption of large
hematomas, hemolytic disorder
• Hepatic jaundice : cholestasis, hepatitis and liver cell toxicity
from drug idiosyncrasy
• Obstruction of the extrahepatic bile ducts
Management of jaundice
Depending on the cause of the jaundice