Discharge letter templates

Surgical patients – elective surgery

Summary:

Name is a blank-year-old gentleman/lady who underwent an elective [procedure] under general anaesthesia. There were no intra- or post-operative complications. As he/she has recovered well on the wards, we are now discharging her.

Information given to GP:

Dear colleague, kindly note the recent admission of this patient.

[Add on any instructions regarding medications or follow-up if applicable.]

Information given to patients:

Please go to your nearest A&E should you become unwell after your operation (e.g. if you experience uncontrollable pain, if you develop a high fever, or if bleeding at your wound site does not stop after applying pressure for 10 minutes).

Please do not drive for at least 2 weeks after your surgery. [Add on other instructions according to type of operation and wound closure.]

After your discharge please leave your dressings on for 48 hours and keep the area clean and dry. It is fine to shower starting around 48 hours after surgery but no baths, pools or hot tubs for at least 2 weeks.

Surgical patients – emergency admission

Summary:

Name is a blank-year-old gentleman/lady who presented with (symptoms). [Describe investigations and findings.] She then underwent [procedure] under general anaesthesia. [Describe intra or post-operative complications.] As he/she has recovered well on the wards, we are now discharging her.

Information given to GP & patients as above. See below for more specifics.

Check operation note and select accordingly.

Post-op care in general

Please do not lift heavy weights (more than 5 kg) for 6 weeks after your operation.

For major abdominal procedures (including bariatric surgery, laparotomies, C-sections, etc)

Post-op care for wound closures

Your stitches are dissolvable and do not need to be removed.

For stitches such as Vicryl and Monocryl.

You will need to go to your GP or a treatment centre for your stitches/staples to be removed.

For stitches such as Prolene, Ethilon (aka nylon), and silk. Information from Geeky Medics.

Skin glue will fall away in 7 - 10 days. Do not pick or rub it off but allow it to come away naturally.

Steri strips will fall away in 7 - 10 days. Do not pick or rub it off but allow it to come away naturally.

Specific operations

Hernia repairs

  • Abdominal hernias: do not lift heavy weights for at least 10 weeks.

Bariatric surgery

  • UHB Trust has their own bariatric protocol, please follow their template for discharge letter.

  • Liquid diet and oral fluids until 14d post-op, then follow advice of dieticians.

  • Avoid heavy lifting for 6 weeks post-op.

  • Enoxaparin for 7d post-op, wear TED stockings for 10d post-op.

  • Diabetes: HbA1c test at 6w, 3mo, 6mo, 12mo as part of follow-up.

  • Continue CPAP if previously on.

  • Medications:

    • T2DM medications: restart metformin only if blood glucose ≥10 mmol/L on two consecutive readings (and no other contraindications). Pts on VRIII or with fasting glucose >10 mmol/L post-op will require basal insulin + refer to inpatient diabetic CNS. Stop all other drugs, restart only advice of diabetic team.

    • T1DM: restart 50% of original dose of basal insulin. Suspend bolus insulin until liquid diet restarted. Refer to inpatient diabetes team before discharge.

    • Continue lansoprazole for 3mo (first 28d should be in orodispersible form).

    • Forceval 1tab OD for 28d, Adcal D3 1tab BDS for 28d – both in soluble/effervescent form.

    • Pain relief – paracetamol and codeine as needed.