Please note that the following is a general guideline only. For a full assessment, exclusion of any other underlying cause for your symptoms and an individualised treatment approach, you will need to be seen by a qualified specialist.
1 General Pre Operative Instructions
Prior to any surgery it is important that necessary precautions are taken to minimise the risk of operative bleeding as well as general anaesthesia. Following are some important pre operative instructions.
1) If you or any blood relatives have tendency to bleed or bruise excessively, please notify the surgeon.
2) Disclose all medical illness to the surgeon and the anaesthetist. By doing so the doctors are able to determine your anaesthetic risk, and do appropriate pre operative investigations and optimise your medical treatment. If there is a need your surgeon may get other appropriate specialists involved for the pre operative work up.
3) If you are a smoker, you must stop smoking for up to two weeks prior to surgery.
4) If you take blood-thinning medications such as Warfarin, Aspirin or Newer anti platelet medications, these need to be disclosed to the surgeon. The surgeon will ask you stop these for 10 days if it is safe to do so, after consultation with your physician. He may cancel surgery if the risk of stopping such medications is too high.
5) There is potential of certain dietary supplements, including garlic, Ginkgo biloba, ginger, ginseng, glucosamine fish oil, and vitamin E, to interfere with hemostasis. These and any other supplements should also be stopped well in advance.
6) Practical matters: Organise sufficient assistance at home. Stay with close proximity to a hospital. Ensure you have some one to drive you to emergency. Have access to a phone. Do not plan travel for at least four week following surgery.
7) If you become unwell prior to surgery, please notify the surgeon and the hospital.
Please read the College of Surgeon’s surgical information sheet given. If you have not received this, have any concerns or wish to speak to your surgeon please contact the reception.
2 Parotidectomy/ Submandibular surgery: Post Operative Care
EARLY POST OPERATIVE PERIOD
You will be admitted to ward with a drain up to two days. Once the drainage become minimal the drain will be removed. Its usual practice to keep the patients admitted with antibiotic cover until all drains are removed.
DRESSINGS
Initial dressings covering the wound will be removed by the surgeon in five days. It is important that you see the surgeon for this and for a wound check.
POST OPERATIVE MEDICATIONS
You will receive antibiotics, pain relief and some ointment to apply after dressing removal.
WOUND CARE
It is important to keep the wound dry the first week. After removal of dressings you may gently clean it. After dressing removal, you will receive antibiotic ointment to apply on the wound, followed by bio oil for a couple of months. You may purchase the bio oil over the counter. Wounds are easily sun burnt; therefore keep the wound protected from sunlight up to three months.
FOLLOWUP
After the first week, it is likely that you will be reviewed at least two times over the following two months. During these visits, the surgeon will discuss the pathology results with you. You must see the surgeon early, if you develop redness, pain or swelling of the surgical site or have any other concerns.
FOOD
Parotid gland/ submandibular glands are major salivary glands. They become activated more, when eating spicy foods or sour foods. In order to prevent excess saliva collection in the surgical site, its advised that you eat bland foods up to three weeks post operatively.
If Concerns
Contact surgeon, the hospital and if an emergency go to closest ED
3 Consent For Your Surgery
Informed consent is a process of finding out information about the recommended treatment, alternative options and weighing up the benefits and risks involved. It is not about just signing a form. This involvesThe diagnosis and likely outcome (prognosis) of your condition
An explanation of the recommended treatment
The risks of the procedure and common side effects
Possible complications
Specific details of the treatment; for example, where it will be performed and who will perform it
Any other options for treatment and their probability of success.
It is not possible, however, to provide complete information or predict outcomes or assess risks with certainty; and patients need to be aware of this uncertainty.
You would also be provided with a official Royal College of Surgeons handout about surgery, which you will be requited to read and understand. If you have any specific matters which you like to further discuss you are requested to contact the surgeon and make another appointment prior to surgery. You have the right to cancel surgery if you wish to do so.
Summary of the risks and complications of Parotid or Submandibular surgery which your surgeon has discussed with you include the following.
1) Pain
2) Numbness
3) Scarring
4) Wound infection, breakdown
5) bleeding
6) Post operative would collections/ swelling
7) Dryness in the mouth
8) Parotid: sweating when eating, paralysis.
9) Submandibular: numb tongue, altered movement of the tongue,
10) partial paralysis.
11) Requirement for further surgery in some cases
12) Anaesthetic risks: will be discussed by your anaesthetist on the day.
YOU HAVE RECEIVED THE FOLLOWING CLINICAL INFORMATION
Three page surgical information documentPrinted surgical information sheet with details
Surgical booking form
Information about the process on the day
You will contact the surgeon if you have any further questions, after reading thru all of the information.
Patient’s Signature
Signature of the Collector
Date
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