Colon Resection Surgery Instructions

About Your Colon Resection Surgery

Things to make sure your physician knows:

• I take a blood thinner. Some examples are aspirin, heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), dabigatran (Pradaxa®), apixaban (Eliquis®), and rivaroxaban (Xarelto®). There are others, so be sure your healthcare provider knows all the medications you’re taking.
• I take prescription medications including patches and creams.
• I take over-the-counter medications including patches and creams.
• I take dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.
  • Patients taking Phenteramine supplements will need to stop them 2 weeks prior to surgery.
• I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
• I have sleep apnea.
  • If you use a breathing device (such as a CPAP device) for sleep apnea, bring it with you the day of your surgery.
• I have had a problem with anesthesia (medication to make you sleep during surgery) in the past.
• I’m allergic to certain medication(s) or materials, including latex.
• I’m not willing to receive a blood transfusion.
  • This will be marked on the consent.
• I drink alcohol.
• I smoke.
  • If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help.
• I use recreational drugs.

About Enhanced Recovery After Surgery (ERAS)

ERAS is a program to help you get better faster after your surgery. As part of the ERAS program, it’s important to do certain things before and after your surgery.

Before your surgery, you’ll have an appointment for presurgical testing (PST). 

You can eat and take your usual medications the day of your PST appointment.

Exercise and eat a healthy diet, avoid shaving the area 2 days prior to surgery.

Getting ready for your surgery

7 days before your surgery

Follow your healthcare provider’s instructions for taking aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding.

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Buy bowel preparation supplies

You’ll need to do a bowel preparation before your surgery. Your healthcare provider will give you a prescription for antibiotics to take as part of your bowel preparation. You’ll also need to buy the following supplies:

• 1 (238-gram) bottle of polyethylene glycol (MiraLAX®). You can get this from your local pharmacy or grocery. You don’t need a prescription.
• 1 (64-ounce) bottle of a clear liquid. For examples of clear liquids, see below.

2 days before your surgery

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

Don’t shave or wax your abdominal area starting 2 days before your surgery. This will lower your risk of getting an infection.

1 day before your surgery

Start your bowel preparation:  Cleansing your bowels with Miralax and antibiotic pills before surgery decreases your risk of infection.

On the morning of the day before your surgery, mix all 238 grams of MiraLAX with the 64 ounces of clear liquid until the MiraLAX powder dissolves. Once the MiraLAX is dissolved, you can put the mixture in the refrigerator, if you prefer.

At 1:00 pm on the day before your surgery, take Neomycin (2 tablets) and metronidazole (1 tablet).

At 2:00 pm on the day before your surgery, take Neomycin (2 tablets) and metronidazole (1 tablet).

At 5:00 pm on the day before your surgery, start drinking the MiraLAX mixture. The MiraLAX will cause frequent bowel movements, so make sure you’re near a bathroom.

• Drink 1 (8-ounce) glass of the mixture every 15 minutes until the container is empty, this will take about 2 hours.
• When you finish the MiraLAX mixture, drink 4 to 6 glasses of clear liquids.
• Apply zinc oxide ointment or Desitin® to the skin around your anus after every bowel movement. This helps prevent irritation.

7:00-10 pm – Drink 24 ounces of the carbohydrate drink (100% pure, no sugar added, white grape juice)

At 10:00 pm on the evening before your surgery, take Neomycin (2 tablets) and metronidazole (1 tablet).

Shower with a 4% chlorhexidine gluconate (CHG) solution antiseptic skin cleanser (such as Hibiclens®)

4% CHG solution is a skin cleanser that kills germs for 24 hours after you use it. Showering with it before your surgery will help lower your risk of infection after surgery. Your nurse will give you a bottle to use before your surgery.

The night before your surgery, shower using a 4% CHG solution antiseptic skin cleanser.

1. Use your normal shampoo to wash your hair. Rinse your head well.
2. Use your normal soap to wash your face and genital area. Rinse your body well with warm water.
3. Open the 4% CHG solution bottle. Pour some into your hand or a clean washcloth.
4. Move away from the shower stream. Rub the 4% CHG solution gently over your body from your neck to         your feet. Don’t put it on your face or genital area.
5. Move back into the shower stream to rinse off the 4% CHG solution. Use warm water.
6. Dry yourself off with a clean towel after your shower.
7. Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Sleep

Go to bed early and get a full night’s sleep.

Morning of Surgery:

Drink 12 oz of the carbohydrate drink (100% pure, no sugar added, white grape juice). You need to finish this 2 hours before your scheduled surgery time. This means that you may need to drink it on your drive to the hospital, depending on the time of your surgery.

If you’re allowed to have red, orange, and purple liquids, you can also have Boost® Breeze, Ensure Clear™, and Diabetishield® nutritional drinks.