Information for patients undergoing or waiting for a surgical procedure.

On 11 March 2020 the World Health Organisation (WHO) confirmed COVID-19 (coronavirus) had spread all over the world (this means it is a ‘pandemic’). Hospitals have very robust infection control procedures but if you catch coronavirus around the time of your surgery it could affect your recovery and might increase your risk of pneumonia and even death. 

At the Guildford hip and knee clinic every patient has a unique care plan that is tailored to each individual’s specific needs. As the pandemic evolves and we learn to live with the virus, Miss Gill will discuss the potential risks of planned surgical procedures with each patient waiting for an operation under her care. If surgery is delayed she will formulate a management plan to help you cope with your symptoms until it is safe to proceed with your procedure.

Currently (March 2022), all hospitals require patients undergoing elective surgery to have a PCR test approximately 3 days prior to admission, once the test has been performed patients are required to isolate at home until admission. This is to keep you, and the other patients on the ward, some of whom may be clinically vulnerable, safe. Unfortunately, it is not possible to completely remove the risk of contracting coronavirus whilst in hospital. It is also not possible to give patients an estimate of how likely they are to contract it. However, there are steps that you can take to significantly reduce your risk of contracting the virus around the time of your surgery.

Before surgery

You will be asked to isolate at home for 3 days before the operation, along with members of your household if you do not live alone. This means that the whole of the household does not leave home for 3 days and can continue to interact with one another as normal.

• The whole household should ensure they do not leave the home (but can use the garden if they have one). 

• When receiving any deliveries or needing to answer the front door, they should observe social distancing to reduce possible spread of the virus. 

Isolating with the whole household may be challenging if there are adults in the household that work away from home during the day. In this scenario it may be more appropriate to ‘shield’ within your household. Here the rest of the household are relatively unaffected, but the individual awaiting surgery ‘shields’ to distance themselves from others in the home, thereby reducing the risk of infection.

What does shielding within the household mean for me?

• Minimise the time other people living with you spend in shared spaces such as kitchens, bathrooms and sitting areas, and keep shared spaces well ventilated.

•  Keep 2 metres (3 steps) away from people you live with and encourage them to sleep in a different bed where possible. If you can, use a separate bathroom from the rest of the household. Use separate towels from the other people in your house, both for drying yourself after bathing or showering and for hand-hygiene purposes. 

• If you share a toilet and bathroom with others, it’s important that they are cleaned every time after use (for example, wiping surfaces you have come into contact with). Consider drawing up a rota for bathing, with you using the facilities first. 

• If you share a kitchen with others, avoid using it while they are present. If you can, take your meals back to your room to eat. If you have one, use a dishwasher to clean and dry the family’s used crockery and cutlery. If this is not possible, wash them using your usual washing-up liquid and warm water and dry them thoroughly. If you are using your own utensils, remember to use a separate tea towel for drying these. 

• Everyone in your household should regularly wash their hands, avoid touching their face and clean frequently touched surfaces. 

It is imperative that you take this request seriously for your own health, for the health of the staff looking after you and for the health of other patients. 

Before you come into hospital you will need to have a swab test for COVID-19. Staff looking after you will also have been tested. If you have had contact with someone infected with coronavirus during your 3 days of isolation you must let the admitting hospital know immediately.

Current guidance is that anyone who has tested positive for Covid-19 should delay non essential elective surgery for 7 weeks after a negative lateral flow test, or from becoming asymptomatic.

On admission

** Please do not travel to the hospital via public transport **

Whilst you are in hospital staff might be wearing some protective equipment, this includes the use of surgical facemasks. If you have hearing difficulties, particularly if you rely on lip reading, please let staff know.

Fast track Surgery

The British Orthopaedic Society have recommended that patients should be discharged home as soon as it is safe to do so thus reducing the risk of contracting coronavirus around the time of your surgery.

Miss Gill, together with a multidisciplinary team of anaesthetists, physiotherapists, occupational therapists, pharmacists and nursing staff have developed a flagship ‘ Fast track ’ hip and knee replacement service. This premier service uses anaesthetic techniques that allow the team to get you out of bed within hours of your surgery, enabling some patients to be discharged to the safety of their own home on the same day as their joint replacement.

In our experience, patients who are not ready to go home on the day of their surgery are usually confident to go home the following day after members of the team have assessed that they are safe to do so.

Please be assured you will not be discharged home until you are safe to go and have fulfilled all of our discharge criteria and goals.

During the current pandemic the safest place to rehabilitate after your surgery is usually at home.

After surgery

There is evidence emerging that patients who contract coronavirus in the weeks immediately before or after surgery have a much higher risk of lung complications or even death. 

It is therefore essential that you continue to take extra precautions for 2 weeks after you have been discharged home. 

___________________________

Miss Gill will discuss your individual level of risk with you prior to planning a date for your operation. After the risks of the surgery itself have been explained to you will be asked to sign a consent form to confirm that you have understood these risks, the risk of covid-19 peri-operatively will form part of these discussions.

The Centre of Perioperative Care have produced guidance for patients undergoing surgery during the COVID-19 pandemic. Please click the link below for access to this publication.

_____________________________

If you have any questions regarding the content of this page, or would like to discuss things with Miss Gill again before your surgery, please contact us.

The contact details for private and NHS patients can be found at the bottom of this page.