What should be done before the operation. Preparation for surgery under general anesthesia. Consider Less Common Techniques

Over the next year, more than fifty million people will lie on the operating table in the United States of America alone. And most of these people, both children and adults, with rare exceptions, will suffer from anxiety and excitement just before the operation. However, many people do not think about more serious psychological problems which may be caused by preoperative anxiety. After all, this side effect, which few people talk about, but which can play a decisive role in the success or failure of the operation. The high level of anxiety before surgery not only leads to difficulties on the day of surgery, but also has a very serious impact on the patient's recovery. Statistics show that forty percent of adults who undergo surgery suffer from high levels of anxiety and negative effects associated with it, both during and after the operation.

There is no doubt that medicine has made incredible leaps in recent decades, but the high level of anxiety remains very serious factor Moreover, its importance and danger have only increased over time. There are many reasons for this trend. One of the main reasons is that modern healthcare is not at its best. high level, as a result of which many programs for the psychological preparation of people for operations in hospitals were eliminated. Also today there is a tendency to unite hospitals. The result is larger institutions that focus much less on the emotional well-being of patients. In addition, traditional social structures such as family or friends are gradually becoming less and less reliable sources of support, even though great amount studies prove that they can give the patient an incomparable advantage.

So how do you mentally prepare for surgery?

Learn about the procedure

Learn as much as you can about the procedure using trusted medical sources, not random blogs on the internet. Many hospitals even offer YouTube videos for those people who are about to undergo some type of routine surgery, such as hip or knee surgery.

Prepare a list of questions

Prepare a list of questions and go through it with your supplier medical services. Research shows that the more information you get before surgery, the less anxiety you will experience during the process.

Chat with experts

Talk to your surgeon and anesthesiologist about the availability of specific medical preparations before the operation. It is not always necessary to take a sedative or pain reliever, but it is always good to be aware of the availability of certain drugs.

Find out more about anesthesia

When you speak with the anesthesiologist, make sure you understand all of your options for dealing with pain after surgery, as planning is the key to a successful recovery.

Use anxiety management techniques

Use guided imagination. On the web you will find a large number of sources that provided you detailed instructions about using guided imagination and a variety of breathing techniques to help you fight anxiety. Practicing these techniques before surgery can be incredibly beneficial.

Listen to music

Music is an incredible tool that has proven its effectiveness over and over again. Instead of just worrying in the waiting room, you should listen to your favorite music.

Consider Less Common Techniques

Other techniques such as aromatherapy, sensory therapy, and therapy using clowns or pets are often used as well. However, it is worth noting that, to date, there is no consistent sound scientific evidence to recommend these therapies on a regular basis.

Ask family and friends for support

And finally, it is impossible to overestimate the importance of systems social support that surround the operation. Friends and family are very important during this period.

This article is for patients. It will tell you how to prepare for surgery on the organs. abdominal cavity(, stomach, intestines, pancreas, gynecological surgery, etc.).

How to prepare for surgery?

Regardless of the diagnosis and volume surgical intervention All patients undergo some preparation for abdominal surgery. As a rule, the doctor tells the patient how to prepare for surgery in each case. We will analyze the general aspects of preparing for surgery, based on the international recommendations of WHO and.

Analyzes (laboratory diagnostics).

The patient must have fresh laboratory tests:

• Clinical Analysis blood with the calculation of the leukocyte formula (the analysis is valid for 7 days);
• Biochemical blood test (ALT, AST, total protein, albumin, creatinine, urea, total bilirubin, direct bilirubin + additional indicators biochemical parameters blood as prescribed by a doctor) (analysis is valid for 7 days);
• Blood group with the determination of the Rh factor (the analysis is valid for 6 months);
• Blood test for hepatitis B and C (test is valid for 6 months);
• Wasserman reaction (analysis is valid for 6 months);
• HIV test (test is valid for 6 months);
• Urinalysis with sediment microscopy (analysis is valid for 7 days).

As a rule, the doctor prescribes these tests not long before the operation. If necessary, can be assigned additional tests(depending on the patient's condition).

instrumental examinations.

Before extensive surgery, the doctor prescribes:

• X-ray of organs chest or fluorography;
• Electrocardiography (ECG);
• Ultrasound examination (ultrasound) of the abdominal cavity and pelvic organs;
• ECHO-KG (according to indications);
• Function external respiration(according to indications);
• Holter monitoring (by indications)
• Computed tomography (CT) (according to indications);
• Magnetic resonance therapy (MRI) (according to indications);

If the disease requires more extensive diagnosis and additional surveys before the operation, the doctor informs the patient about it.

Conversation with a doctor.

The attending physician always conducts a conversation with the patient before the operation. He will talk about the surgical intervention, why it should be carried out, talk about the possible risks and complications of the procedure. Try to prepare your questions in advance so that the doctor can answer them during the conversation. Also, on the eve of the operation, the anesthesiologist conducts a conversation with the patient about the upcoming operation and about the anesthesia.

Diet before surgery

As a general rule, follow special treatment nutrition is not required unless it has been previously prescribed by a doctor. However, according to international ERAS recommendations, it has been proven that if a patient is malnourished and his body mass index (height-weight ratio, height-to-weight ratio) is less than 18.5 points, then enhanced protein-carbohydrate nutrition within 7 days before surgery. For severely malnourished patients, enhanced nutrition is indicated 14 days before the expected date of surgery.

Hunger before surgery.

Taking medication before surgery.

If the patient is receiving regular therapy for their disease(s), it is worth discussing with the doctor which medications should be taken or not taken prior to surgery. As a rule, drugs that affect blood viscosity are canceled 7 days before the planned surgical intervention. However, without the consent of the doctor, it is not worth canceling the prescribed therapy on your own.

Bowel preparation before surgery.

There are two types of bowel preparation:

• Mechanical (enema);
• Oral (taking macrogol preparations - a laxative drug with osmotic properties used to cleanse the intestines).

The doctor informs the patient about the need for mechanical or oral bowel cleansing before the operation. The procedure for mechanical preparation of the intestine is performed by a nurse the day before the operation and on the day of the operation before being taken to the operating room.

Removal of hair from the body.

Hair is the source of infection. They are one of the sources of postoperative infectious complications. Therefore, removing body hair before surgery is a must. Hair, if present, is removed from the neck, chest, abdomen, groin, and upper third of the thigh. There are two options - shaving or machine haircut.

According to the latter, a machine haircut is preferable, since shaving operating field causes micro cuts in the skin, which can lead to infection. It is also recommended to shave your face. If during the operation intubation is performed (placement of a breathing tube in the trachea for machine breathing), it will be convenient for the anesthesiologist to fix the breathing tube to a shaved face.

Hygienic shower.

The patient is obliged to take a hygienic shower (thorough washing skin with soap) in the evening before surgery and in the morning before going to the operating room) to reduce the risk of infectious complications.

Bandaging the legs before surgery.

In some cases, bandaging of the legs is required before surgery to prevent vein thrombosis. lower extremities. This is reported by the doctor on the eve of the operation. You can use an elastic 5-meter bandage, or individual compression underwear (stockings) of the 1st degree of compression.

Bandaging of the feet nurse. The patient should be in the supine position. The procedure is carried out immediately after a night's sleep in the supine position, or after the patient is lying with his legs up for 5-10 minutes. Compression underwear put on immediately after a night's sleep in a lying position, or after the patient is lying with his legs up for 5-10 minutes.

Delivery to the operating room.

The patient is brought into the operating room naked. There should not be any items of clothing on the body, as well as jewelry, piercings, etc. If the patient has a manicure or pedicure, it must be removed (in some cases, anesthesiologists look at the color of the nail plate to assess tissue oxygen saturation).

Compression bandage after surgery.

About the need to wear postoperative bandage for the prevention of postoperative ventral hernias, the doctor reports additionally.

Total.

I described in as much detail as possible how to prepare for a surgical operation on the abdominal organs. Depending on the disease and on the proposed surgical treatment, there may be an additional necessary information which the doctor conveys to his patients before surgical treatment.

Recommendations for the preoperative period include examination, preparation of the intestine for surgery, consideration of wearing a postoperative bandage and compression stockings, nuances of nutrition, behavior, restrictions physical activity in postoperative period, processing of seams, features of registration of legal documents and others.

The optimal timing for performing surgery, for women, is from the 7th to the 20th day menstrual cycle(counting from the first day of menstruation). In the case of performing hysteroscopy in order to diagnose intrauterine pathology (endometrial polyp, endometrial hyperplasia, intrauterine synechia, submucosal uterine fibroids, uterine endometriosis, chronic endometritis), I recommend performing the operation immediately after the end of menstruation in order to increase its diagnostic value.

Admission to the clinic is carried out on the day or on the eve of the operation - it depends on the access and the volume of the proposed surgical treatment, the need preoperative preparation. In the clinic you will spend from 4 hours to 5 days, strictly individually. All the food and drink you need is available - you do not need to bring anything. The clinic has about 16 postoperative diets, allowing each patient to individually select nutrition for the purpose of a speedy recovery.

It is very important that at the time of the operation the patient is healthy, that is, there is no cough, runny nose, fever, liquid stool and so on. If you have had any diseases inflammatory nature, for example, SARS, exacerbation chronic bronchitis, otitis, tonsillitis, then at least 2 weeks must pass from the moment of recovery to maximize the restoration of the body's immune forces. The skin should not have pustular and inflammatory rashes. If available herpetic eruptions on the lips or genitals, then the operation should be postponed until complete recovery, since a decrease in immunity in the perioperative period may lead to generalization herpetic infection.

Of course, I understand that every woman, even on the operating table, should look very good and well-groomed. But for the period of surgical treatment, you should refuse to use cosmetics, it is also inappropriate to perform a manicure and pedicure specially before the operation. Anesthesiologists will ask you to wash cosmetics and remove nail polish.

In case of chronic diseases (cardiovascular, endocrinological, respiratory, urinary system, diseases of the gastrointestinal tract), it is advisable to consult a specialist in this problem in advance, having received permission for the operation, as well as additional recommendations in case, for example, an increase blood pressure in the early postoperative period.

In the presence of varicose veins of the lower extremities, obesity, diabetes, oncopathology of any localization at the present time and in the anamnesis in the preoperative period, it is necessary to undergo duplex scanning of the vessels of the lower extremities to exclude the presence of blood clots in the vessels and prevent thromboembolic complications.

When planning laparoscopy in patients with increased body weight and concomitant bronchopulmonary pathology, I recommend that you evaluate the function of external respiration.

If you are taking any drugs (for example, Thrombo ACC, antihypertensive, hypoglycemic or for thyroid gland) - it is necessary to inform the attending physician and the anesthesiologist about this. Often therapy needs to be adjusted.

Examination before surgery

The examination plan before the operation is determined only after the initial consultation by the operating gynecologist. Of course, there are tests that I recommend to perform for all patients before surgical treatment of various sizes. The minimalism of surveys, which seems convenient in the modern rhythm of life and the current economic situation, is not applicable when we are talking about surgical treatment. A professional approach should be carried out not only in surgical treatment, but also in the examination of the patient before surgery. Your health is of the utmost importance to me.

You can be examined at the place of residence - in the clinic or antenatal clinic. But it happens that while some test results are being prepared in the clinic, others expire.

There are also a number of large medical network laboratories in Moscow, which are located at almost every metro station. When passing the examination in a private laboratory, having passed the tests in the morning around 9 am, you will receive some of the results by the end of the working day, and the rest - the next morning. It is important that most of the laboratories have the opportunity to send the results of the examination to you and your future attending physician by e-mail. This allows you to save the patient's time, as well as in case of changes in the examination, timely appoint an additional examination or reschedule hospitalization. The examination is carried out in the morning on an empty stomach or 8 hours after the last meal and water. Also, on the eve of the examination, it is worth limiting spicy, fatty, fried, salty, smoked foods, alcohol intake.

In our clinic, you can have a complete examination 1 day before the operation.

All analyzes must be original, with seals and consistent expiration dates.

It is not necessary to donate blood type and Rh factor, as in our medical institution the blood transfusion laboratory independently determines the group affiliation and about 14 more various systems for the selection of blood components for a possible transfusion.

There is an unspoken rule in our medical institution - we take on surgical treatment patients only in the presence of at least 1000 ml of erythrocomponents and 1000 ml of fresh frozen plasma. A specialized blood transfusion laboratory independently selects and delivers blood components for each patient. We do not force the patient's relatives to donate blood at blood transfusion stations. We are not deficient in blood components.

Be sure to bring with you the data of previous examinations (if they were carried out): the results of ultrasound, electrocardiographic, echographic studies, protocols of computed and magnetic resonance imaging, extracts from other medical institutions.

List of the main examinations that must be performed before surgical treatment:

1. Complete blood count (shelf life 14 days).
2. Biochemical blood test: blood glucose, AST, ALT, urea, creatinine, total and direct bilirubin, total protein, serum iron(shelf life 14 days).
3. Coagulogram, hemostasiogram - assessment of the blood coagulation system: VSK, prothrombin index, APTT, fibrinogen, antithrombin III (shelf life 14 days).
4. Hospital complex: blood for syphilis, HIV, hepatitis B and C (shelf life - 3 months).
5. Blood type and Rh factor (if you are planning to be operated on outside our medical institution) - only a stamped form is accepted (shelf life is for life).
6. Urinalysis (shelf life 14 days).
7. Smears from the cervix for oncocytology (shelf life 6 months). This analysis is taken strictly in the absence spotting from the genital tract.
8. Smears from the cervix and vaginal mucosa for flora and purity (shelf life 14 days). This analysis is taken strictly in the absence of bleeding from the genital tract.
9. Electrocardiogram (shelf life 10 days).
10. Chest x-ray or fluorography (shelf life 12 months).
11. Ultrasound of the kidneys and Bladder(shelf life 1 month).
12. Ultrasound of the abdominal cavity (shelf life 1 month).
13. Consultation by a therapist (shelf life 14 days).

For some gynecological pathologies I can ask you to perform additional examinations and consultations:

1. Aspiration biopsy of the endometrium (shelf life 1 month).
2. office hysteroscopy with aspiration biopsy endometrium (shelf life 3 months).
3. Ultrasound examination of the abdominal cavity, kidneys, bladder and retroperitoneal space (shelf life 3 months).
4. Echocardiography (shelf life 1 month).
5. Assessment of the state of the function of external respiration - forced spirometry (shelf life 1 month).
6. Fibroesophagogastroduodenoscopy (shelf life 1 month).
7. Colonoscopy or sigmoidoscopy (shelf life 1 month).
8. Extended colposcopy (shelf life 3 months).
9. Hormonal examination of the patient's blood (shelf life 3 months).
10. Examination for STIs and bacteriological cultures from the MPP (shelf life 3 months).
11. Hysterosalpingography (shelf life 12 months).
12. Consultation with an endocrinologist, gastroenterologist, pulmonologist, anesthesiologist-resuscitator, proctologist, phlebologist, cardiologist, urologist (shelf life 3 months).
13. Computed or magnetic resonance imaging of the small pelvis, kidneys, abdominal cavity and retroperitoneal space (shelf life 3 months).

Documentation issues

From the day of admission to the clinic, a disability certificate (sick leave) is issued for the duration of your stay in the hospital, and after discharge it is extended by the doctor of the clinic or at the place of residence.

If there are several places of work, the required number of disability certificates for each place of work is issued.

Upon admission, you need to clarify the exact name of the place of work in the personnel or accounting department.

On the eve or on the day of surgical treatment, consents are signed for the expected scope of the operation and for the transfusion of blood components.

On the day of discharge from the hospital, 3 main documents with seals are issued to the patient's hands - the protocol of the operation, the results of the planned and urgent histological examination, discharge summary. The discharge summary indicates the final diagnosis, all the results of the examination, the name of the operation, recommendations that should be followed after the operation.

Bowel preparation

2-3 days before surgery, I recommend a slag-free diet (exclude unpeeled vegetables and fruits, wholemeal bread, fatty varieties meat, fish and poultry, cabbage). Depending on the access and volume of surgical treatment, 1-2 cleansing enemas before surgery: on the evening before and in the morning on the day of surgery.

1. White bread, flour products from refined cereals, crackers.
2. White rice.
3. Vegetables without skins or seeds, preferably steamed.
4. Fruit without skin or seeds.
5. Limited milk and yogurt.
6. Boiled lean beef, poultry, fish.
7. Broths.
8. Jelly, honey, syrup.
9. Eggs.
10. Low-fat cottage cheese.

You can drink without restrictions until the last 8 hours before the operation.

If you have an admission on the day of the operation, then you must come to the clinic strictly on an empty stomach. Do not eat or drink 8 hours before the operation.

When taken vital important drugs you need to put them under the tongue and dissolve or drink 1 sip of water.

During hot times of the day, subject to availability intense thirst you can rinse your mouth with plain boiled water.

Preparation of the operation area

Shaving the pubic area and labia at home is not necessary. Hygienic treatment of the perineum and anterior abdominal wall is performed on the day of surgery in a hospital to minimize the risk of inflammation of the hair follicles and excessive trauma to the skin. In preparation for reconstructive plastic surgery on the walls of the vagina and muscles pelvic floor hygienic preparation of the perineum and vaginal walls is carried out strictly by medical personnel. Especially carefully it is necessary to wash the navel area and remove the piercing earring at home.

Compression stockings

Hospital compression anti-embolic hosiery - modern and sufficient effective remedy prevention of blood clots, as well as blockage of deep veins of the lower extremities and pulmonary artery during the perioperative period.

Surgical intervention is a provoking factor in the blood coagulation system in the direction of hypercoagulability, and forced immobility during and after surgery slows down the movement of blood in the veins. Together, this increases the likelihood of thrombosis. The use of stockings reduces the likelihood of thrombosis by several times; therefore, it is mandatory for most surgical interventions, not only gynecological profile. For the same reason, during the operation, I use in necessary cases a special hardware compression system Kendell (Switzerland), which stimulates blood flow in the legs, simulating walking. I also ask you to activate as soon as possible after the operation: turn in bed, perform flexion and extension movements, get up as early as possible (after the permission of the doctor). Together, this significantly reduces the risk of thrombosis and thromboembolism.

The use of hospital knitwear provides narrowing of the lumen of the veins, normalization of the valves of the veins of the lower extremities, acceleration of venous blood flow towards the heart due to graduated pressure (compression) of 18-21 mm Hg. Art. on soft tissues and the walls of the veins of the legs. Graduated compression - physiologically distributed pressure on the leg, maximum in the ankle area and gradually decreasing towards the thigh, which is set during the manufacture of knitwear.

Each manufacturer has its own table for selecting hospital compression stockings. Someone uses the ratio of height and weight, someone uses the circumference of the lower leg and thigh. The following measurements must be taken better in the morning when there is no swelling of the lower extremities):

1. Ankle circumference.
2. Leg circumference.
3. Mid-thigh circumference.
4. Thigh circumference 5 cm below the crotch.
5. Growth.
6. Leg length from the floor to the knee / to the middle of the thigh.

Having them at hand, it will be possible to accurately select the exact size that you need. And the accuracy of selection is very important, since the compression of hospital stockings is not evenly distributed, but graduated - 100% falls on the area above the ankles, 70% - on the shin area and 40% - on the thigh area.

You can use bandages, but they are less hygroscopic, uncomfortable to wear, as they constantly “slip”, are poorly fixed, the degree of compression is determined by the skills of bandaging the legs, and quickly lose their properties.

Stocking manufacturers also take care of the antimicrobial and anti-allergic properties of their products, using a special porous knitting structure, impregnating the threads with antimicrobial compounds, avoiding the use of latex. Such stockings are held by a silicone tape in the upper part of the stocking (as in ordinary women's stockings), and the degree of compression is constant.

Important: the compression created should be 15-23 mm. rt. Art. (manufacturers call this prophylactic compression or class 1 compression), it is desirable that the toe is open and that your stocking size is correctly selected.

If you still have varicose disease lower extremities, we definitely recommend that you consult a phlebologist ( vascular surgeon) for a more detailed compression ratio. Compression level #1 just might not be enough for you.

Now, having made all the measurements, you can go to the pharmacy or orthopedic salon.

Manufacturer table

Postoperative bandage

If you plan to perform a laparotomy (abdominal surgery), then on the second day after the operation, when you get out of bed, you will be put on a postoperative bandage. It should not be purchased. After laparoscopic operations, a bandage is not required.

The bandage is a wide strip of elastic material that fastens with Velcro (other fastening options are less convenient). The main task of the postoperative bandage is to support the anterior abdominal wall, reducing the load on injured abdominal muscles. This improves the healing process. postoperative suture, minimizes the likelihood of hernias and hematomas, normalizes intra-abdominal pressure, relieve pain.

The bandage is selected individually depending on the circumference of the abdomen and hips. They also differ in width: from 20 to 30 cm. For most women, a bandage 23-25 ​​cm wide is suitable. After fastening, it should fit snugly against the body, but not squeeze the stomach very much. It should be comfortable. It is necessary to put on a bandage lying down.

Postoperative treatment

After the operation, you will receive antibacterial, anti-inflammatory drugs, drugs that reduce the uterus. At discharge, I recommend, as a rule, for 5 days to continue taking antibiotics and anti-inflammatory drugs. It is very important in the postoperative period to monitor bowel movements. It is desirable to process the seams once a day (antiseptic, sticker change). On the 7th-10th day we invite you for the treatment of postoperative wounds, examination and ultrasound. Both when performing laparoscopy and laparotomy, I always apply intradermal cosmetic sutures that do not require further removal. By the same day, the histology is ready, and I give further recommendations.

I am always in touch with patients. I am always happy to answer you by phone or e-mail if you have any questions.

Recommendations for the perioperative period include preoperative examination, preparation of the intestine for surgery, consideration of wearing a postoperative bandage and compression stockings, nuances of nutrition, behavior, limitation of physical activity in the postoperative period, processing of postoperative sutures, nuances of legal documents, and others.

The optimal timing for performing surgery for women is from the 7th to the 20th day of the menstrual cycle (counting from the first day of menstruation). You arrive at the clinic on the day of the operation. Spend 1-3 days in the clinic. All the food and drink you need is available at the clinic - you don’t need to bring or bring anything!

It is very important that at the time of the operation the patient is healthy, i.e. there is no cough, runny nose, fever, loose stools, etc. recovery should take at least 2 weeks to maximize the restoration of the body's immune forces.The skin should not have pustular and inflammatory rashes.If there are herpetic rashes on the lips or genitals, then the operation should be postponed until complete recovery, since a decrease in immunity in perioperative period can lead to generalization of herpes infection, up to herpetic encephalitis.

In case of chronic diseases (cardiovascular, diseases of the gastrointestinal tract, etc.), it is advisable to consult a specialist in this problem in advance, having received permission for the operation. In the presence of varicose veins of the lower extremities, increased weight, in the preoperative period, it is necessary to undergo duplex scanning of the vessels of the lower extremities to exclude the presence of blood clots in the vessels and prevent thromboembolic complications!

If you are taking any medications (for example, thrombo ass or sugar-lowering drugs), you must inform your doctor! Often, therapy needs to be canceled or adjusted.

Examination before surgery

On this page you will find list of examinations that must be passed before the operation and explanations are given why this or that analysis is necessary.

Excessive "minimalism" of the survey, which seems convenient in the conditions of the modern rhythm of life, is not acceptable when it comes to surgical treatment. Your health is of the utmost importance to us! And professional approach here also plays a decisive role!

You can be tested at your place of residence.
In our clinic, you can have a complete examination 1 day before the operation.
All analyzes must be original, with seals.
Even if the blood type is in the passport, you must have a form - it is needed in the medical history!
Be sure to bring with you the data of previous examinations (if they were carried out): the results of ultrasound, MRI, CT, hysteroscopy and WFD, etc.

Documentation issues:

the clinic issues a sick leave from the day of hospitalization, and in the future it is extended for the required period either by a doctor at the clinic or at the place of residence. For correct design sick leave we ask you to bring the exact name of the place of work with you. An official agreement on the operation is concluded with the clinic, you receive all the relevant documents in your hands. Discharge summary(document) issued in last day hospitalizations; the protocol of the operation is entered into it and detailed recommendations for the management of the postoperative period.

Bowel preparation:

On the eve before the operation, you can afford a light dinner (yogurt, porridge, kefir, cottage cheese). You can drink without restrictions until the last 8 hours before the operation;

On the day of the operation, you must come to the clinic on an empty stomach! Do not eat or drink 8 hours before the operation!

Preparation of the operation area

Shaving the pubic area and labia is not necessary! (To minimize the risk of developing inflammation of the hair follicles). It is necessary to trim this area so that the length of the hair does not exceed 0.4-0.5 cm at the time of the operation. We ask you to wash the navel area especially carefully and remove the piercing earring (if any).

Compression stockings

Hospital compression anti-embolic knitwear is used to prevent the formation of blood clots and blockage of deep veins of the lower extremities and pulmonary artery by them during the perioperative period.

Any operation affects the blood coagulation system, and immobility during and after the operation slows down the movement of blood in the veins. Together, this increases the likelihood of thrombosis. The use of stockings or golf reduces the likelihood of thrombosis by several times, in this regard, it is mandatory for most gynecological operations. For the same reason, during the operation, we use, if necessary, a special hardware compression system "Kendell" (Switzerland), which stimulates blood flow in the legs, simulating walking. We also ask you to activate as soon as possible after the operation: turn in bed, move your legs, get up as soon as possible (as soon as the doctor allows). All together, this significantly reduces the risks.

How does hospital stockings work? By creating compression, it maintains normal blood circulation in the vessels, prevents venous stasis and the formation of blood clots.

How to choose the right size jersey? Each manufacturer has its own selection table. Someone uses the ratio of height and weight, someone uses the circumference of the lower leg and thigh. It is necessary to take the following measurements (preferably in the morning):

• 1. Ankle circumference
• 2. Calf circumference
• 3. Mid-thigh circumference
• 4. Thigh circumference 5 cm below the crotch
• 5. Growth
• 6. Weight
• 7. Leg length from floor to knee / to mid-thigh

Having them at hand, it will be possible to accurately select the exact size that you need. And the accuracy of selection is very important, because the compression of hospital stockings or golf is not distributed evenly, but graduated - 100% falls on the area above the ankles, 70% on the shin area and 40% on the thigh area.

Stockings or stockings? Stockings are required for your operation.

Stockings or bandages? You can use bandages, but they are less hygroscopic, not comfortable to wear, because they constantly “slide”, can cause allergies, are poorly fixed, the degree of compression is determined by the skills of bandaging the legs, and quickly lose their properties.

Stocking manufacturers also take care of the antimicrobial and anti-allergic properties of their products, using a special porous knitting structure, impregnating the threads with antimicrobial compounds, avoiding the use of latex. To keep such stockings due to the silicone tape in the upper part of the stocking (as in ordinary women's stockings), and the degree of compression is constant.

Important: the compression created should be 15–23 mm. rt. Art. (manufacturers call this prophylactic compression or class 1 compression), it is desirable that the toe is open and that YOUR stocking size is correctly selected.

In the event that you have varicose veins, you need to consult with a vascular surgeon and choose the degree of compression that is right for you!

Is hospital stockings the same as regular varicose stockings? Not quite, but certain conditions they are interchangeable and if you have anti-varicose stockings or stockings, you can use them.

Will these stockings come in handy after surgery? Yes. They can be used when traveling on airplanes, during pregnancy and childbirth.

Now, having made all the measurements, you can go to the pharmacy or online store.

Remember that if you are planning abdominal operation(laparotomy), it is also necessary to purchase a postoperative bandage.

Manufacturer table

Postoperative bandage

After laparotomic (open) surgery, you will need a postoperative bandage. After laparoscopic operations, a bandage is not required.

The bandage is a wide strip of elastic material that fastens with Velcro (other fastening options are less convenient). The main task of the postoperative bandage is to support the anterior abdominal wall, reducing the load on the abdominal muscles. This improves the healing process of the postoperative suture, minimizes the likelihood of hernia formation, normalizes intra-abdominal pressure, relieves pain.

The bandage is selected individually depending on the circumference of the abdomen and hips. They also differ in width: from 20 to 30 cm. For most women, a bandage 23–25 cm wide is suitable. After fastening, it should fit snugly against the body, but not squeeze the stomach very much. It should be comfortable. It is necessary to put on a bandage while lying down.

Postoperative treatment

After the operation, you will receive antibacterial, anti-inflammatory drugs, drugs that reduce the uterus. At discharge, we recommend, as a rule, to continue taking antibiotics and anti-inflammatory drugs for 3-4 days. It is very important to monitor the stool in the postoperative period. It is desirable to process the seams once a day (antiseptic, sticker change). On the 7th day we invite you to remove the stitches, examination and ultrasound. By the same day, the histology is ready, and we give further recommendations.

We are always in touch with our patients. We are always happy to answer you by phone if you have any questions or by e-mail. Most of our patients try to come to us for at least some control ultrasound, the rest send ultrasound data by e-mail; we adjust the treatment.

Ask questions or book a consultation

“When you write a letter, know that it gets to my personal e-mail. I always reply to all your emails. I remember that you trust me with the most valuable thing - your health, your destiny, your family, your loved ones, and I do my best to justify your trust.

Every day I answer your letters for several hours.

By sending me a letter with a question, you can be sure that I will carefully study your situation and, if necessary, request additional medical documents.

Huge clinical experience and tens of thousands of successful operations will help me understand your problem even at a distance. Many patients require surgical care, and properly selected conservative treatment while others need urgent operation. In both cases, I outline the tactics of action and, if necessary, recommend additional examinations or emergency hospitalization. It is important to remember that some patients require prior treatment of concomitant diseases and proper preoperative preparation for a successful operation.

In the letter, be sure (!) to indicate the age, main complaints, place of residence, contact number and address Email for direct communication.

So that I can answer all your questions in detail, please send along with your request scanned conclusions of ultrasound, CT, MRI and consultations of other specialists. After studying your case, I will send you either a detailed answer or a letter with additional questions. In any case, I will try to help you and justify your trust, which is the highest value for me.

Yours sincerely,

surgeon Konstantin Puchkov

Proper preparation for general anesthesia (narcosis) or regional anesthesia and surgery has a huge impact on the comfortable and safe conduct of anesthesia and the smooth course of the postoperative period, and the patient's condition after anesthesia.

Before the upcoming anesthesia and surgery, you will have to undergo a comprehensive diagnostic examination, including: general analysis blood, blood type, biochemical analysis blood, detailed coagulogram, urinalysis, ECG, fluorography or radiography of the lungs. According to the indications, consultations of narrow specialists and additional examination methods are prescribed. After receiving the results of the tests, additional methods of examination, you will have a conversation and examination by an anesthesiologist.

During a conversation with an anesthesiologist before the operation, it is necessary to inform about the diseases you have suffered, injuries, operations, what kind of anesthesia was used for this - general or local anesthesia and how it went, the presence of allergies to medicines, food products, natural ingredients(pollen, down, animal hair). Tell about the presence of concomitant diseases, constant medication. In a confidential conversation with an anesthesiologist, one should not hide information about the transferred and comorbidities, since it is necessary for right choice methods of anesthesia and the choice of drugs for anesthesia, which will ensure the safety of anesthesia in you and avoid complications of anesthesia and the postoperative period. Aware means armed!

Before anesthesia if present concomitant pathology it is necessary to achieve maximum compensation and remission of diseases (for example: stabilization of blood pressure with arterial hypertension, correction of arrhythmia in supraventricular and ventricular extrasystole and atrial fibrillation, normalization of glycemic levels in diabetes mellitus).

In the presence of acute respiratory symptoms viral infection(SARS), flu (nasal congestion, lacrimation, headache, runny nose, itching, sore throat, cough, fever) planned surgical treatment or procedure under general anesthesia should be delayed until complete recovery. Usually it is two weeks for acute respiratory viral infections (rhinitis, pharyngitis, laryngitis) and four weeks for bacterial infection bronchi, pneumonia or tonsillitis.

In each individual case, the terms will be determined by the anesthesiologist and the operating doctor. Any surgical intervention is a stress for the body, weakening immune system. When the immune system is weakened, there is increased risk infections infectious diseases or the risk of progression of an existing infection. A serious problem of conducting anesthesia for a cold is the manifestation of an existing acute respiratory viral infection, influenza, up to the development of complications. respiratory system for example: purulent bronchitis, pneumonia. Changes in the body's response to drugs for anesthesia are possible. It is important not to hide the presence or recent ARVI, flu, tonsillitis and other acute infectious or other diseases before the upcoming anesthesia and surgery for your own safety. It is easier to postpone surgical treatment and anesthesia, and not harm yourself, than to deal with complications!

If you have loose teeth or loose crowns, bridges, carious teeth, then you must first undergo treatment with a dentist, as there is a high risk of damage to loose teeth and crowns, it is possible that fragments of teeth and crowns may accidentally fall into the trachea, bronchi while ensuring airway patency during anesthesia.

You can not cancel the medicines on your own, change the dosage and frequency of taking the medicines that you take with concomitant pathology. The question of canceling drugs, changing the dosage, frequency and method of taking drugs is decided with an anesthesiologist, surgeon, gynecologist, urologist, therapist or specialist at a preliminary examination in preparation for surgery and anesthesia. Be sure to take all your medications with you to the hospital. You will continue to take the drugs you are taking after anesthesia and surgery. It is allowed to take medications in the morning on the eve of anesthesia. How to take and when to take it will be explained to you by the anesthesiologist before anesthesia during a conversation.

We ask you not to use cosmetics before anesthesia, remove varnish, gel from nails(at least from 1-2 fingers) to ensure monitoring of oxygenation indicators (oxygen content in capillary blood) during anesthesia and the postoperative period. Nail polish and gel make it difficult and distort the oxygenation of the blood. This will avoid and prevent complications of anesthesia.

Before anesthesia and admission to the operating room, it must be removed and left in the ward contact lenses, glasses, Jewelry(rings, earrings, chains, bracelets, hair clips, piercings). Before anesthesia, it is necessary to leave removable dentures in the ward.

And in conclusion, about one of the most important conditions for conducting general and regional anesthesia that is safe for you. Anesthesia is performed on an empty stomach. In the morning before anesthesia, you can’t drink water (if you suddenly drank a little, took a sip of water, forgot that you shouldn’t drink - anesthesia will be delayed or transferred to the next day !!!), liquids, tea, coffee, juice, take any food, enjoy chewing gum, sucking candies, mints. Morning allowed hygiene procedures oral cavity - you can brush your teeth, but without swallowing water. An empty stomach is one of the guarantees to avoid the most dangerous and formidable complication of anesthesia as the ingress of acidic stomach contents into Airways and can reduce the symptoms of nausea and vomiting after anesthesia.

Subject to these requirements and conditions, anesthesia in our Clinic will be comfortable and as safe as possible, and we hope it will leave you with only pleasant emotions.

If you have any questions, you want to learn more about the methods modern anesthesia used in our Clinic, the possibility and choice of the method of anesthesia for your pathology or your concomitant diseases, come to the Clinic, we will answer all your questions at a meeting!