Day Surgery

Our day surgery hospitals are accredited against the National Safety and Quality Health Standards (NSQHS) and approved by all of the major health funds. Have peace of mind that you are in a world class facility where staff are dedicated to providing the highest standard of care, in a safe and caring environment.
Day Surgery2019-03-06T13:47:30+10:00

Surgery at The Skin Hospital

The Skin Hospital undertakes many different types of surgery. Your doctor will discuss the type of surgery that will be appropriate for your particular condition

Types of surgery that may be indicated are:

  • General Excision Surgery for specific types of skin cancers and other lesion
  • Mohs Micrographic Surgery – this is a highly specialised form of skin cancer surgery. See details below about Mohs
  • Plastic Reconstructive Surgery
  • Oculoplastic Surgical Repairs
  • Cosmetic Surgery

If you are required to have surgery at The Skin Hospital, the procedure, fees and expected outcomes will be discussed during your consultation with your doctor. The doctor will also provide the date and time of your surgery.

Prior to the surgery, you may be contacted by the Day Surgery Coordinator Nurse, who will advise you of any pre-operative preparation plans, discharge plans, community services that you may require after discharge and your follow up appointments.

To ensure that your visit with us goes smoothly we would ask that you read through the Day Surgery pages thoroughly as it provides essential information for your surgery. Alternatively, you can download the Day Surgery Booklet here.

Mohs Surgery

In regards to Mohs surgery, the removal of each layer of tissue takes approximately 1-2 hours. Only 20-30 minutes of that time is spent in the actual surgical procedure; the remaining time is needed for slide preparation and for the doctor to review the slides.

On average, 2-3 layers of tissue (called stages) will be removed prior to clearance of the cancer. The whole process, including suturing the wound, usually takes between 4-6 hours. Some difficult or larger cases may take even longer. This may result in you needing to stay for the whole day.

How long will the surgery take?

Your doctor will indicate the estimated duration of your specific surgery during your consultation.

In regards to Mohs surgery, the removal of each layer of tissue takes approximately 1-2 hours. Only 20-30 minutes of that time is spent in the actual surgical procedure, the remaining time is needed for slide preparation and for the doctor to review the slides.

On average, 2-3 layers of tissue (called stages) will be removed prior to clearance of the cancer.

The whole process, including the sewing up the wound, usually takes between 4-6 hours. Some difficult or larger cases may take even longer. This may result in you needing to stay for the whole day.

Pre-Admission Preparation

  • The best preparation for surgery is a good nights sleep, followed by a substantial breakfast. However, if you are having a general anaesthetic you will be required to have no food or drink from the time specified by The Skin Hospital preadmission nurse.
  • To reduce the chances of infection, shower and wash your hair the night before or the morning of your surgery. Sleep in fresh night-wear and clean bed linen. Some patients may be asked to use special solution to wash their body or hair prior to the surgery.
  • Do not wear make-up, hair spray, body lotion or perfume on the day of your surgery.
  • Do not stop taking any of your prescription medication unless instructed by your surgeon.
  • Discontinue vitamin and mineral therapy for at least two weeks prior to the surgery to reduce the risk of heavy bleeding during and post surgery eg. Fish Oil, Krill, Vitamin E, Ginko, Garlic & Ginger tablets.
  • Leave anything of value, such as jewellery, at home. We cannot accept responsibility for the loss of valuables or money.
  • Wear comfortable, loose-fitting clothes, such as a tracksuit, pants, a cardigan, a short-sleeved shirt or blouse. An old button up shirt is preferable. It is wise to bring a book or magazine to read.
  • At home, please have Panadol or Panadeine for pain relief, and an ice-pack or pack of frozen peas to use to reduce bruising / swelling / bleeding. Be aware that Panadeine requires a script from your doctor or GP.
  • Please arrange for a relative or friend to accompany you home, either by private transport or taxi. You must not go home on public transport or drive following your surgery. It is most important that you do not go home alone and that you have company / assistance overnight. If you decide to go home alone you will be required to sign a release form before surgery so you are aware you are taking on this responsibility for yourself

Medication

  • Please bring with you any medications you need to take during your stay.
  • If you are a diabetic requiring regular blood glucose levels recorded please bring in your own monitor to ensure currency of readings throughout the procedure.

Admission – on the day of your day surgery

You will be asked to arrive 30 minutes before your operation so please arrive ahead of the arranged time. It is important to be punctual to avoid delays. Please note that although very rare, the doctor could be delayed in surgery and there may be some waiting period before your procedure.

After arriving at The Skin Hospital, please proceed to reception and register. If you have not already  completed a Patient Profile (admission form), you will be asked to do so. The reception staff will then show you to the waiting area.

What to bring:

  • A list of your current prescribed medication
  • Medicare card and/or DVA card
  • Health Fund card
  • Credit card, EFTPOS card, bank cheque or cash for payment
  • Your eye glasses and case. If you wear contact lenses, you will not be able to wear them during the procedure, please bring your lens case for storage.
  • Dentures, hearing aids and the containers to store them.
  • Any mobility aids, such as walking sticks, or walking frames.

Our staff will advise you on your estimated discharge time. Please arrange for a relative or friend to accompany you either by private transport or taxi.

You must not go home on public transport or drive following your surgery. It is also important that you do not go home alone and that you have the assistance of a responsible adult overnight.

For your comfort

We have a designated recovery area for our patients where there are reclining lounge chairs, magazines and television as well as some light refreshments (tea, coffee, biscuits).

Mobile Phones

Mobile phones are not permitted in the operating theatre.

Interpreter Service

If the services of an interpreter are required, please contact us prior to your admission, so the necessary arrangements can be made. There may be a cost associated with this service.

Smoke-Free Environment

As legislated by NSW Health, smoking is prohibited in all areas within the day surgery. This includes all entrances and external areas.

Privacy Policy

The Skin Hospital complies with the requirement outlined by the Health Records and Information Privacy Act 2002 (NSW) (HRIP Act) which protects the privacy of health information in New South Wales and ensures security and privacy of an individual’s health information and promotes privacy and trust between patients and their heath care providers. If you would like a copy of our privacy policy or wish to make a privacy complaint, please contact:

Email: secretary@skinhospital.edu.au
Post: The Secretary,
Level 3, No. 7 Ashley Lane
Westmead NSW 2145
Phone: 02 8651 2047

Discharge

Recovering at Home

  • Once you arrive home:
  • You should rest for at least 12-24 hours.
  • Do not drive a motor vehicle for 24 hours after surgery.
  • Avoid operating complex or dangerous machinery, or doing anything that requires you to be alert and coordinated for 24 hours after surgery.
  • A nurse will contact you the next day to check on your progress.
  • Contact your doctor if you have any concerns.

What To Expect After Surgery

After surgery you will be left with a surgical wound. This wound will have been repaired in one of the following ways:

  • Healing by spontaneous granulation i.e. allowing the wound to heal itself; this takes about 4-8 weeks and requires daily dressing changes.
  • Primary closure with stitches that remain in place for approximately 5-14 days.
  • Other skin closures, such as a skin graft, skin flaps, or reconstructive procedures.
  • Referral and reconstructive surgery by a plastic or oculoplastic surgeon.

Risk and Complications

All surgery carries risks and complications .These may include bruising, swelling, bleeding, infection, numbness, scarring, and skin tightening or stretching. Most of these problems will resolve with time, however you will always be left with a scar.

Swelling and bruising are very common, especially when surgery is performed around the eyes and nose. Swelling can be alleviated by keeping your head elevated for the first 48 hours and by using ice-packs regularly for the first 24 hours following surgery. If redness and pain don’t subside within two days, or if the wound begins to drain or discharge, you may have an infection and you should contact your doctor or The Skin Hospital.

Nerve damage can occur, however it is usually temporary. It can be permanent if the cancer is extensive and the nerve is involved. Scarring from the surgery usually settles well. Flaps and grafts take time to heal and improve significantly within 3–6 months. Sometimes the extent of skin cancer and the complexity of the wound may require a larger reconstruction that may result in a more obvious scar.

Your post-operative care will be thoroughly explained to you by a nurse and you will also be given written instructions.

Pain

You will feel some discomfort after your surgery. We request that instead of taking aspirin or disprin, use Panadol or Panadeine for pain relief.

Bleeding

This occurs occasionally following surgery. If this should happen, the bleeding can be controlled by the use of pressure. Leave the dressing in place and apply pressure with a gauze or similar pad. You may support yourself against a couple of pillows in a semi-upright position and apply constant pressure over the bleeding site for 20 minutes.

Swelling

This is common around the surgical site. It can be minimised by applying ice packs (or frozen peas) on the area for 10 minutes, every hour for up to 24 hours after surgery.

Wound Care

You will be given instructions on how to care for your wound after your surgery and arrangements will also be made for your sutures to be removed. Some patients will be asked to return to the Skin Hospital the day after surgery to have their wound checked.

Sporting Activities/Travel

Do not make arrangements for sporting activities or travel after your surgery as you will need to rest for at least one week to prevent post-operative complications. We also advise that you do not undertake strenuous exercise for at least one week or more after your sutures have been removed.

Post-Surgery After Care

Hygiene

By practising good hygiene, you can reduce the risk of getting sick or passing infections on to others in the day surgery.

What can you do to reduce the spread of germs?

  • Wash your hands often:
    • when they are dirty
    • after sneezing or coughing
    • before and after handling food
    • after going to the toilet
    • after touching commonly used items
  • Wipe down all frequently touched surfaces regularly as some germs can live on surfaces for several days.
  • Cover your mouth and nose for coughs and sneezes as infectious droplets can remain in the air for some time.
  • Discard used tissues immediately, and then wash your hands.

Preventing Falls

After your procedure, you may be more susceptible to falls.

To reduce your risk of falling:

  • Ask about the likelihood of falling and your risk factors
  • Know what assistance you require and follow the instructions of the nurse. If you have been requested to get help, ring the nurse bell before moving about.
  • Stand up slowly after lying down or sitting. Sit on the side of the bed for a few minutes before getting up to prevent dizziness. Take care when bending down, bend at knees only and steady yourself before walking.
  • Wear comfortable, fitting, flat shoes that grip -don’t walk around in socks or ill-fitting slippers.
  • Use handrails, if available
  • Do not leave clothes or bags on the floor.
  • Bring walking aids with you.

Above all, be sensible and recognise your limitations while in hospital. Do things safely by following the nurses’ instructions.

Preventing Pressure Injuries

Pressure injuries are caused by unrelieved pressure that damages the skin and underlying tissue. People unable to move after surgery may get pressure injuries even after as little as 1-2 hours.

What can you do to reduce your risk of pressure injuries?

  • Inspect your skin at least once a day for a break in the skin
  • Pay special attention to reddened areas on the skin that remain after you have changed positions.
  • Change positions regularly – every two hours while in a bed and every hour while in a chair.
  • Avoid contact with plastic surfaces such as plastic chairs.
  • Avoid direct contact between bony prominences, use cushions.
  • Avoid overheating your body.
  • Use/wear pads or briefs that have a quick drying surface, or creams and ointments to protect the skin from moisture exposure.
  • Use warm (not hot) water and mild soap when bathing/showering.
  • Treat dry or flaky skin using barrier creams or oils.
  • Eat a well-balanced diet – protein and calories are very important.
  • Drink plenty of water.

Use of Antibiotics

The Skin Hospital follows the guidelines outlined in the National Safety and Quality Health Standards. One of those standards is preventing and controlling healthcare associated infections. The Skin Hospital follows the guidelines to restrict the needless use of antibiotics in all its surgical cases.

Don’t be surprised if you do not receive routine antibiotics before or after your surgery. It is recognised that there is a group of patients who, due to their current illness or health status, may need antibiotics. Patients will be treated accordingly. It is important to know that the Standard is aimed at limiting antimicrobial therapy – not to deny therapy.

What can you do to reduce the spread of germs?

By practising good hygiene, you can reduce the risk of getting sick or passing infections on to others in the day surgery by doing the following:

  • Wipe down all frequently touched surfaces regularly as some germs can live on surfaces for several days.
  • Cover your mouth and nose for coughs and sneezes as infectious droplets can remain in the air for some time.
  • Discard used tissues immediately
  • Wash your hands:
    • when they are dirty
    • after sneezing or coughing
    • before and after handling food
    • after going to the toilet
    • after touching commonly used items

It is important to be aware of your rights and responsibilities as a patient.

Patient rights

While in our care, we respect your right to:

  • Privacy and the maintenance of personal dignity, and to be treated with care and consideration.
  • Expect all communication and written records pertaining to your care to be treated as confidential by medical and other staff.
  • A clear, concise and understandable explanation by your doctor of your condition, procedure, possible side effects and any associated risks
  • Receive from your doctor, information necessary to give informed consent, prior to the start of any procedure.
  • Ask for a second opinion about your proposed treatment. This may be impractical in an emergency situation.
  • Withdraw consent and refuse further treatment at any time.
  • Receive an explanation of all costs pertaining to your procedure and stay.
  • Be informed by your doctor and staff of requirements for continuing health care following discharge.
  • Know the identity and professional status of individuals involved in your care.
  • Information about the The Skin Hospital’s mechanism for the initiation, review and resolution of patient’s concerns and complaints; information on the procedure for taking complaints to the Health Care Complaints Commission.
  • The provision of resources and support for patients with special needs wherever possible.

Patient responsibilities

While in our care, you have the responsibility to:

  • Provide accurate and complete information about current symptoms, past illness, hospitalisation, medications and other matters relating to your health.
  • Indicate if you do not understand your proposed treatment and expected outcome.
  • Follow the agreed treatment plan recommended by your doctor.
  • Be considerate of the rights of other patients and staff.
  • Provide accurate details of your Medicare and/or private health insurance.
  • Promptly settle payment of any uninsured component of your account.
  • Respect the property of other persons and The Skin Hospital.
  • Accept the consequences if you refuse treatment or do not follow your doctor’s instructions.
  • Arrange suitable transport home after your operation or procedure.

Patient details

It is important that we have your correct contact details as, occasionally; a clinic may have to be cancelled at short notice due to illness or other circumstances. Please advise The Skin Hospital if you change your address or telephone number.

Right of complaint

We value your feedback and would like you to let us know if you are happy/unhappy with any aspect of our service or if you have any suggestions as to how we can improve our service. Patients do have the right to complain and there is an information booklet published by the Health Care Complaints Commission on your rights and responsibilities as a health consumer. These are available at the reception desk for you to read, if you so desire.

Payment of Patient Bills

A payment system has been set up with our bank for the payment of patient bills.

This system will accept Mastercard or Visa payments.

The Payway billercode is : 158170.

Click Here to make a payment.: PATIENT PAYMENT

Thank you for your payment.

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