Pre-Operative Checklist

Hasham M. Alvi, MD Adult Joint Reconstruction 847-285-4200

Pre-Operative Checklist

It is important to complete this checklist entirely to avoid delaying your surgery.

4 to 6 weeks prior to surgery:

Appointment with your Primary Care Physician for medical optimization and to complete all labs outlined on labs sheet

Complete lab work as ordered by your primary care doctor

Dental evaluation (Within 6 months of surgery)

Contact your insurance company (See Page 10 for additional information)

10 to 14 days prior to surgery:

Stop taking anti-inflammatory medications and supplements (Page 11)

Pick up Chlorhexidine soap & Mupirocin nasal ointment from your pharmacy (Prescription will be sent electronically from Dr. Alvi's office (Page 6) Please make sure we have the correct pharmacy information)

Schedule an appointment with Dr. Alvi to discuss any final questions regarding your surgery if you have not seen him within one month of your surgery

5 days prior to surgery:

Start cleaning routine. Please read Page 2 for further instructions

Schedule your Post-Operative appointment, which should be close to 2 weeks after surgery

You will have to go to the laboratory at the hospital you will be having surgery at within 5 days prior to your surgery to have a TYPE & SCREEN drawn (This must be done otherwise you will be unable to proceed with surgery)

Day before surgery:

The hospital will call you in the late afternoon to tell you what time to arrive at the hospital and to answer any last minute questions

Do not eat, or drink, anything past midnight unless instructed by the anesthesiologist

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Hasham M. Alvi, MD Adult Joint Reconstruction 847-285-4200

Have your walker or crutches ready to bring to the hospital

CLEANING INSTRUCTIONS FOR YOUR SKIN BEFORE SURGERY

The most common infections after surgery involve bacteria that are normally found on the skin. These bacteria are commonly found on healthy people. You can play an important part in reducing the risk of an infection at your surgical site by practicing good skin hygiene prior to surgery.

We will send a prescription to your pharmacy electronically for two different antiseptic cleaning supplies:

? Chlorhexidine gluconate soap ? You will use the chlorhexidine gluconate soap (Hibiclens) as your body wash while showering for the 5 days before your surgery.

? Mupirocin nasal ointment ? You will use this nasal ointment as instructed by the pharmacist for the 5 days before your surgery

***Do not use the soap if you are allergic to chlorhexidine gluconate. Please alert the physician if you develop a rash while using the soap***

Please follow these instructions:

1. You will shower with the CHG (Hibiclens) each day at night for 5 days prior to your surgery. For example, if you are scheduled to have surgery on Monday, you will start using the CHG (Hibiclens) on the Wednesday the week before your surgery. If your surgery is on a Thursday, you will start this on the Saturday before.

2. Do not shave any body parts from the neck down (underarms or legs) for 2 days prior to surgery.

3. The CHG soap should only be used on your body below the neck. DO NOT USE ON THE EYES, FACE, GENITAL, AND RECTAL AREAS.

The Day Before Surgery

The day prior to your surgery, you will shower as previously outlined. You can shower at any time at night but complete the shower at least one hour before going to bed.

1. Do not use powder, perfumes, or lotions on your skin for 24 hours prior to surgery.

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Hasham M. Alvi, MD Adult Joint Reconstruction 847-285-4200

2. Wear clean, comfortable clothes to the hospital. Do not bring any valuables to the hospital due to the risk of loss or theft.

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Hasham M. Alvi, MD Adult Joint Reconstruction 847-285-4200

Potential Risks and Complications

With any type of major surgery, there are risks and complications. Dr. Alvi previously went through a consent form regarding these during one of your office visits. Please review the list below and be aware of any signs or symptoms related to these complications. Report them to Dr. Alvi or your Primary Care Physician immediately. If you feel that it is a life threatening emergency, please go straight to your local ER or call 911.

1. Blood Clots (DVT) or Pulmonary Embolism (PE): Prolonged immobilization can reduce blood flow in the legs, increasing the risk for blood clots in leg veins (deep venous thrombosis, or DVT). The blood pools in the lower extremities and is not pushed back to the heart via muscle contractions in the legs like when walking. This clot can become dislodged and head to the lungs which is called a pulmonary embolism, or PE. A PE can kill someone within minutes. It is very important to use the TED hose, anti-coagulants, ankle pumps, and walking to decrease your chance of either.

Signs/Symptoms: - Calf swelling and pain - Calf redness - Changes in skin color - Shortness of breath - Difficulty breathing - Chest pain - Sweating

***It is very important to inform Dr. Alvi if you have a history or family history of blood clots, bleeding disorders or pulmonary embolism***

2. Infection: There can never be a zero chance of infection after a total joint replacement. We try to reduce this risk by having you complete the cleaning routine to your skin starting five days in advance from surgery. Most infections start as a superficial skin infection and can go deep into the knee joint if not treated. It is important to clean and monitor your incision as described in the post-op section of this manual.

Signs/Symptoms: - Increased redness - Pus like drainage - Fever (101.0 and higher) and chills

3. Heart Attack: A heart attack can affect anyone after a total joint replacement whether you have a heart condition prior to surgery or not. If you have any of these indications, you should go to the closest ER immediately for a cardiac workup.

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Hasham M. Alvi, MD Adult Joint Reconstruction 847-285-4200

Signs/Symptoms: - Chest pain - Shortness of breath - Left sided jaw, arm, or shoulder pain - Sweating - Nausea and/or vomiting

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