Prior to surgery the child will attend a ‘pre-assessment’ clinic appointment. He or she will see a member of the surgical team, a pre-operative assessment nurse and also possibly a physiotherapist. The surgeon will explain the operation in detail including the benefits, risks and any alternative treatments. If the child and family are happy to proceed with surgery, an adult with parental responsibility will sign a consent form.
The pre-assessment nurse will ask about the child’s other medical problems and medications. If needed, the child will be assessed by a member of the anaesthetic team. The pre-assessment nurse will take swabs from the child to ensure they do not carry MRSA. The swabs involve a cotton-wool bud being gently wiped in the nose, throat and groin.
MRSA is a bacterium that can be found on the skin of healthy individuals. It can become problematic in the presence of a skin wound. If MRSA is found, the family will be contacted by a member of the team and treatment will be given prior to surgery.
Being admitted to hospital
Most children are admitted to hospital on the morning of surgery. Occasionally children are admitted the day before. The family will be given clear instructions about when the child should stop eating and drinking prior to surgery. It is very important that these instructions are followed. Failure to do so could result in cancellation of surgery.
The child will usually be admitted to F3 ward. A bed will be allocated on arrival and the child will be asked to change into a theatre gown. A member of the surgical team and anaesthetic team will review the child on the ward. The nurse will advise whether the child is allowed water to drink.
The child will walk to theatre if able to do so. Both parents can accompany the child. If needed, the child will be taken to theatre on a chair or bed.
Once the child arrives in the anaesthetic room, a ‘check-list’ will be performed by the surgical team. Once the child is asleep, parents will be asked to leave the anaesthetic room. Parents will be given a pager as they leave.
Once surgery is finished, the child will be transferred to the recovery room. Once the child is awake and comfortable, parents will be contacted on the pager. They can then go to the recovery room. The child will be transferred from the recovery room back to the ward when ready.
The orthopaedic team will decide when it is safe for the child to go home. As a minimum, they must have passed urine, had something to eat and drink, be able to safely mobilise and be comfortable. Depending on the child and the type of surgery, some children go home on the same day as surgery and some children remain in hospital for a few days. Probable length of in-patient stay should be discussed with the surgeon pre-operatively.
Before discharge, the child and family will be given a discharge summary and any prescribed medications. The hospital does not provide paracetamol and ibuprofen. Please ensure that you have these at home prior to your child’s admission.
Going back to school
The timing of return to school will be discussed in the pre-assessment clinic. If a plaster cast or walking aid is planned post-operatively, you should let the school know about this in advance so they can make any necessary changes. We aim to allow your child to return to school as soon as it is safe to do so. We aim to avoid long absences from school.
A follow-up appointment is requested after surgery. The timing of follow-up varies between one week and several months. A member of our team will contact the family approximately 2 weeks after discharge to check how the child is recovering. If there is a query about your follow-up appointment, this can be addressed at this time.