Operation at St Luke’s Surgery
Where are we?
The Pinfold Health Centre is a large building near the ASDA at the corner of High street and Pinfold/Field Road, in Bloxwich, Walsall. After you enter the building, take the glass door to the left hand side: St Luke Surgery has the first reception desk . Please come to our reception about 15 minutes before the scheduled time.
On the day; You should have your normal food and drink on the day. You should also take all your normal medication, except blood thinners (see below).
When you arrive
When you report to the reception, you will be booked in and handed a consent form. The consent form makes you aware of all the risks and complications of surgical procedures. Please make sure you can read the consent or have some one who can read and explain it to you. Please give yourself enough time. Although we make every effort to do the operation on time, it can be delayed on occasions
Pre -Operation
Please ask the nurse or doctor to clarify any information you do not understand. The doctor will examine you, speak to you, and come to a shared decision if the operation is appropriate. We may not be able to do the operation in certain circumstances as stated at the end. In other words, this appointment does NOT guarantee the operation. It will be done only if the doctor feels it is appropriate. The procedure, possible complications and recovery time will be explained to you. The surgical team will then go through a ‘WHO checklist’ to make sure the procedure can go ahead safely.
Operations are done after injecting a local anaesthetic solution to numb the area. If you feel any pain at all after the numbing injection, you must tell the doctor and he will inject more local anaesthetic. (There are no brownie points for being stoic!)
Post Operation: At the end of operation the wound may be stitched or cauterised. If the stitches are non- dissolving it will have to be removed either by your own practice nurse or us. If you want us to remove the stitches please book an appointment at the reception desk before you leave. You will be given a leaflet on post-operative care before you leave. You can contact us if there is any undue pain, swelling, redness or discharge.
Suture Removal.
If sutures are non-dissolving, they need to be taken out depending on the area of body. If you fail to get them removed, they will get stuck or cause infection.
In general, the approximate times for this are as follows
- Face 5 days
- Hand & Scalp 7 days
- Trunk 10-14 days
- Back &Limbs 14 days
Histopathological Examination: In NHS patients, all surgically removed tissue or swelling will be sent to Laboratory for examination. The results of this examination will be available on computer (Fusion) in about 4 weeks. If the result requires further treatment we will contact both you and your doctor for needed action. Normal results requiring no action is communicated only to your doctor. However you must make sure you know the result by contacting us on 01922 775515 Tue/Wed/Thu 11.00 to 3.00PM. Your own surgery also can tell you the results. This is because on rare occasions a benign looking skin lesion can turn out to have cancer in it on Laboratory examination.
Car Parking. There is limited Car parking at the Pinfold Health Centre. However there is free council car park across the road/Leisure centre. The car park at ASDA can also be used if you have some shopping at the store or use the Pharmacy there. You can usually find some parking on the side roads off the Field Road. Parking can be scarce on Wednesday morning and coming in good time to find parking would be sensible.
Bus and Train Buses are frequent and convenient. 31, 32,9,19, and X51 stop nearby. Bloxwich North rail station is about 15 minute walk away, but trains run at about 60 minutes interval.
Cosmetic and Procedures of Limited Clinical Value.(PLCV)
Many people have moles or lumps or skin tags that are benign and not causing any symptoms. There is no ‘Medical need’ for removal. These are deemed as cosmetic removals and are not funded on the NHS. If on examination it is deemed to be a PLCV, the operation will not be done on the NHS. (However we may be able to do this privately. Private operations cost between £100 and 350)
Some other condition may need operating only in certain situations. If these yardsticks (criteria) are not met, again operation, will be declined.
Suspected Cancer.
We are not allowed to operate on any skin lesion suspected of being malignant. You will either be referred back to your doctor or sent to the appropriate specialist by a 2week fast track referral.
Adverse Outcome
This is not a life threatening condition and can be left alone.
Operation will generally cure it, but some swellings can come back.
• There will be a scar. The scar is usually thin and flat. Rarely it may be prominent and not good looking, especially if it gets infected. Very rarely it can hypertrophy and look ugly. Very, very rarely it can develop into a Keloid which can be much worse than the original lump. Removing the keloid may result in even bigger lump. You can look up on internet to see pictures of Keloid.
• Complications like delayed wound healing, redness, stiffness with prolonged recovery, recurrence, prolonged pain, contracture, etc. varies widely from 0.1 to 10%.
• Infection after minor surgery is rare. Our infection rate is less than 1%. However it can cause the wound to open up and then heal slowly over several weeks. Rarely it can lead to deep infection of body cavities, joint or tendon sheath leading to many months of pain, hospitalisation and end up in permanently stiff painful finger or joint. Very, very rarely it can end up in sepsis with a death rate of up to 50%. All serious infections lead to varying degrees of permanent disability.
• If the operation is in the vicinity of a nerve there is a possibility of nerve damage. Nerve damage can result in numbness of the area, face, finger or painful neuroma. Damage to a nerve to a muscle can result in permanent paralysis of the muscle.
• Operation on limbs can result in a condition called Complex Regional Pain Syndrome. CRPS can result in many months’ stiff painful fingers/limb & treatment; in the end a stiff and painful finger.
- Other Complications not mentioned here can occur
• Serious complications such as mentioned are rare, but if it happens you would wish you never had opted for the operation.
- You should also consider the risk of contracting Covid by coming for surgery in a shared premises such as the Pinfold.
The lump removed at operation will be sent for examination in the laboratory to look for any Cancer. Please ring us or email us or your doctor in 3-4 weeks’ time for the result. Please do not take no news as good news
IMPORTANT.
If you have any allergy to local anaesthetic or dressings or latex rubber please let us know in advance.
If you are on blood thinning medication like Warfarin (Stop for 3 days) Rivaroxaban, Apixaban Edoxaban etc (stop for 48 hours)
The operation will NOT be done if it is deemed to be cosmetic or near major blood vessels or nerves or too big and not safely done in primary care.