A Patient Guide to Surgery
Preparing for Shoulder Surgery
General Preparation
Preparing your home for rotator cuff surgery is essential to ensure a smooth and comfortable recovery. Here are some steps you can take to get your home ready:
Pre-Surgery Planning:
Arrange for someone to assist you during the first few days after surgery. You may need help with everyday tasks.
Home Accessibility:
Clear pathways: Remove any obstacles or clutter that could impede your movement. Ensure there are clear pathways to essential areas like the bathroom, bedroom, and kitchen.
Handrails: Install handrails or grab bars in the bathroom and along staircases to provide support when moving around.
Bedroom Setup:
Use extra pillows to create a comfortable sleeping position that supports your arm and minimizes movement.
Purchasing a wedge pillow help create an inclined position that most patients prefer to sleep in
If you have a recliner, consider preparing the space around it for sleeping.
Bathroom Modifications:
Install a raised toilet seat to make sitting down and standing up easier.
Place a shower chair or bench in the shower to enable seated bathing.
Attach a handheld showerhead for easier bathing while seated.
Kitchen Preparation:
Stock up on easy-to-prepare, nutritious meals, or arrange for meal delivery during your initial recovery period.
Keep essential items within easy reach on countertops or lower shelves to avoid stretching or reaching.
Clothing and Dressing:
Choose loose-fitting clothing with front closures (buttons, zippers) to make dressing easier.
Consider purchasing or borrowing clothing that opens on the side for minimal arm movement.
Assistive Devices:
Invest in or borrow assistive devices like a reacher/grabber to help you pick up items from the floor or high shelves.
Consider using a backpack instead of a shoulder bag to carry items.
Medications and Supplies:
Organize your medications in advance, and have a schedule for taking them.
Stock up on ice packs or consider purchasing an ice machine.
Stop Tobacco and Nicotine Products
Tobacco and Nicotine products have been demonstrated to negatively impact healing from surgical interventions
It is recommended to stop Vaping/smoke inhalation of any kind as early as possible prior to surgery.
Transportation:
Arrange for transportation to and from the hospital on the day of surgery.
It is not recommended to drive while wearing a sling due to slowed reaction time, please make arrangements for postoperative visits and physical therapy appointments.
Entertainment and Comfort:
Create a comfortable and relaxing recovery space with entertainment options like books, movies, or streaming services.
Keep a phone or communication device nearby in case you need assistance.
Emergency Plan:
Make sure someone knows your situation and can assist in case of an emergency.
Remember that your specific needs may vary based on the type of shoulder surgery and your individual circumstances. Consult with your Dr. Abildgaard or your physical therapist for personalized advice on preparing your home for a successful recovery.
What to Wear After Shoulder Surgery
After shoulder surgery, it's essential to wear clothing that allows for easy dressing and accommodates the post-operative restrictions and your comfort. Here are some clothing recommendations:
Loose-Fitting Clothing: Choose loose-fitting clothing, especially tops and shirts, to avoid putting strain on your shoulder while dressing or undressing. Button-down shirts or zip-up hoodies can be easier to put on and take off.
Front-Closure Bras (for women): If you're a woman, consider wearing a front-closure bra that doesn't require reaching behind your back. This can make it much easier to get dressed without putting stress on your healing shoulder.
Elastic Waistbands: Opt for pants or shorts with elastic waistbands. This eliminates the need to pull up or button pants, which can be challenging after rotator cuff surgery.
Slip-On Shoes: Choose slip-on shoes instead of ones with laces or buckles to avoid bending over and straining your shoulder while putting on footwear.
Larger Size Clothing: You may want to wear clothing that is slightly larger than your usual size to ensure that it doesn't put pressure on your shoulder or restrict your range of motion.
Assistive Devices: Consider using dressing aids like a reacher or a dressing stick to help you put on and take off your clothes more easily.
Front Pocket Clothing: Garments with front pockets can be helpful for carrying small items or keeping your hands free when you need to.
Layered Clothing: Layering can help you adjust your clothing to your comfort level throughout the day without having to completely change your outfit. It also allows for easy access to your surgical dressing or sling.
Product Examples - These are some product examples that patients have used in the past and our commonly recommended by Occupational Therapists:
Sleeping After Shoulder Surgery
Sleeping comfortably after shoulder surgery can be challenging. You will be required to wear your sling at night until released by Dr. Abildgaard. Wearing your sling during the day helps to keep your arm in the proper position and provides protection; this is true at night as well.
Tips to aid with sleeping at night:
Sleep in an incline position - Many people prefer to sleep in a recliner chair for the first few weeks to aid with discomfort. Alternatively, using extra pillows or a wedge pillow can provide a similar effect.
Apply ice before sleep: A cold compress can aid with reducing inflammation and decrease pain before sleep, making it easy to fall asleep. To properly ice your shoulder, do not place ice or cold compress directly against skin and take care not to fall asleep with compress on - ice for no more than 30 minutes.
Extra Pillows: If sleeping on your back, place an extra pillow under your elbow to prevent your arm from drifting back or to your side. Typically, most patients are most comfortable at night with the arm resting on the body and the elbow supported by extra pillows.
Side Sleepers: Side sleeping is possible, but recommended to sleep on the nonoperative side. To do this, place extra pillows in front of your body to aid with supporting your arm/hand and sling. Stacking pillows around yourself can aid with preventing you from flipping onto your other side unconsciously in the night.
Instructions for Benzoyl Peroxide Wash
Instructions for Using Chlorhexidine Wipes Before Surgery
1. Timing
Use Chlorhexidine wipes on the morning of your surgery, after your shower.
2. Preparing
Shower First: Take a shower with regular soap and water before using the Chlorhexidine wipes. Ensure you rinse off all the soap thoroughly as Chlorhexidine should not be mixed with regular soap.
Dry Your Skin: Pat your skin dry with a clean towel before using the wipes.
3. Using the Chlorhexidine Wipes
Wipe Down Surgical Area: Use the wipes to gently cleanse the area where the surgery will be performed. This typically should include the front and back of the knee, along with half way up thigh and down calf. If instructed, you may need to wipe other areas as well, such as the torso or limbs.
Avoid Sensitive Areas: Do not use the wipes on your face, eyes, ears, mouth, genital area, or any open wounds. Hibiclens can be irritating to these areas. Wash your hands after use.
4. After Application
Let the Skin Air Dry: Allow the area to air dry completely. Do not rinse the skin after using Chlorhexidine wipes.
Wear Clean Clothing: After using the wipes, put on clean, loose-fitting clothing. Ensure that your bed linens are also clean.
5. Precautions
Do Not Use on Broken Skin: Avoid using Chlorhexidine on any broken skin, open wounds, or rashes unless instructed by your doctor.
Avoid Applying Lotions or Deodorants: After using the Chlorhexidine wipes, do not apply any lotions, creams, powders, or deodorants as these can interfere with the antiseptic effect.
By following these instructions, you can help reduce the risk of infection during and after surgery. If you have any questions or concerns, it’s best to contact your healthcare provider.
Skin Preparation - Before Surgery
Although infection following shoulder surgery is relatively rare, there is evidence that using topical Benzoyl Peroxide (BPO) Gel on your shoulder may help to further decrease this chance. This gel is sold over-the-counter and is frequently advertised as “acne treatment.” It can be found at pharmacies or purchased online. For the treatment below, recommend Benzoyl Peroxide 10% wash.
Instructions for Use:
Begin the treatment 2 days before surgery with showering. You will apply 3 times total:
2 days before surgery, 1 day before surgery, and the morning of surgery.
Cleanse the surgical site with Benzoyl peroxide 10% wash by using solution over the operative shoulder and axilla.
Apply the solution to the shoulder and wait 3 minutes before washing away.
Do not use after surgery.
Cryotherapy
Cryotherapy or cold therapy, is an important and effective way to decrease pain and swelling following surgical intervention. “Ice Machines” are very popular for patients, but unfortunately are rarely covered by insurance (please check with your physician and DME office to check for availability). Typically, HSA/FSA funds can be utilized for purchasing. Research studies have shown that ice packs can be equally effective at the intended effect, but lack the convenience that ice machines can offer. If you elect to use an ice machine, please be sure to follow the appropriate guidelines to avoid injury such as frostbite.
General recommendations for use:
Follow Manufacturer's Instructions: Always read and adhere to the manufacturer's guidelines and instructions provided with the ice machine. These instructions typically include information on assembly, operation, and maintenance.
Check for Damage: Before each use, inspect the ice machine and its components for any signs of damage, such as cracks or leaks. Do not use the machine if it appears damaged.
Cleanliness: Ensure that the ice machine, its hoses, and any accessories are clean before each use. Use mild soap and water to clean them, and thoroughly rinse to remove any soap residue.
Proper Placement: Place the ice machine on a stable surface near an electrical outlet. Make sure the machine is level to prevent any spills or leaks.
Monitor Skin Sensation: Pay attention to how your skin feels during icing sessions. It's normal to feel numbness and cold, but if you experience any discomfort, numbness, or skin irritation, stop the icing session immediately.
Limit Duration: Avoid prolonged or continuous use of the ice machine. Follow your healthcare provider's recommendations regarding the duration and frequency of icing sessions. Generally sessions should be limited to 20-30 minutes with sessions every 2-3 hours for the first few days following surgery.
Use a Barrier: Place a cloth or towel between the skin and the ice pack to prevent direct contact and potential skin damage, such as frostbite.
Monitor Temperature: Keep an eye on the temperature of the ice water or air produced by the machine. Extreme cold can cause tissue damage, so ensure that the temperature is comfortable and not too cold for your skin.
Take Breaks: If using the ice machine for an extended period, take breaks to allow your skin to warm up and prevent overexposure to cold temperatures.
Discontinue Use if Problems Arise: If you experience any adverse reactions, such as increased pain, swelling, or skin irritation, discontinue use of the ice machine and consult your healthcare provider for further guidance.
Video Preparation
Rotator Cuff Repair
This animation provides an example of an arthroscopic rotator cuff repair. There are many techniques for rotator cuff surgery. Typically the tendon has torn away from the bone, and surgery is undertaken to reestablish the connection of the rotator cuff tendon to the bone. This animation utilize suture anchors for the repair.
Shoulder Biceps Tenodesis
Biceps tenodesis involves detaching the native insertion of the Long head biceps at the superior labrum, and reattaching to a point on the humerus bone. This example utilizes an “onlay” technique with a suture anchor placed into the head of the humerus.
Reverse Shoulder Replacement
A reverse shoulder replacement is commonly performed in the setting of arthritis, non-repairable rotator cuff tears, or rotator cuff arthropathy. This animation provides an overview of the surgical procedure.
Narcotic Safety
Narcotic medications or opiates are commonly prescribed for surgery. Please review the following video for expectations regarding pain medications, possible side effects. The link below contains additional information.
Overview of Arthroscopic Shoulder Surgery with emphasis on
Rotator Cuff Repair Surgery:
In this presentation you will find an overview of rotator cuff anatomy and function, along with examples of rotator cuff surgery. Postoperative information and recovery is reviewed as well as a review of Arthroscopic shoulder surgery risks and anesthetic risks.
Arthroscopic Labral Repair/Instability Surgery
This animation reviews a commonly utilized technique for repairing a shoulder labral tear. This surgery is typically performed for instability (dislocations/subluxations), but can also be performed for pain.
Arthroscopic assisted - AC Joint Reconstruction
Injury to the AC (Acromioclavicular) joint can often be treated nonsurgically. If a patient desires to move forward with surgery, there are a multitude of techniques that have been described. This intervention aids to restore the stability AC joint, improve shoulder cosmesis, as well as decrease pain and improve function.
Reverse Shoulder Replacement
A reverse shoulder replacement is commonly performed in the setting of arthritis, non-repairable rotator cuff tears, or rotator cuff arthropathy. This animation provides an overview of the surgical procedure. The procedure is entitled “reverse” due to flipping the standard anatomy of the shoulder. In this procedure, a new ball (glenosphere) is placed on the socket (glenoid) side, and a new socket or cup is placed on the ball side (humeral head).
Sling Use
Using a sling after shoulder surgery is crucial for proper healing. Typically, you will be fit a sling at your preoperative appointment. Please remember to bring the sling with you at the time of surgery as your arm will be placed into the sling prior to waking up from anesthesia. Here are some tips to ensure you're using it correctly and comfortably:
1. Proper Sling Positioning
Ensure the sling supports your forearm and wrist while keeping your elbow at a 90-degree angle.
The sling should hold your arm close to your body to minimize movement.
2. Adjust the Straps
Adjust the straps so your arm rests comfortably without strain. It should not pull on your neck or shoulder.
The sling should not be too tight or too loose; it should feel supportive without causing discomfort.
3. Keep Your Hand Elevated
Keep your hand slightly elevated above the level of your elbow to reduce swelling.
You may need to adjust the sling or prop your hand on a pillow when sitting or lying down.
4. Wear Clothing that’s Easy to Put On
Choose loose-fitting tops or button-up shirts that can be put on and removed without disturbing the sling.
Avoid tight sleeves that could press against your shoulder or arm.
5. Maintain Good Posture
Stand and sit upright to avoid putting extra pressure on your shoulder.
Avoid slouching, which can strain your neck, shoulder, and back.
6. Follow Your Surgeon’s Guidelines
Always follow the specific instructions given by your surgeon or physical therapist regarding sling use, including how long you should wear it.
Never discontinue use of the sling early, unless instructed by your healthcare team.
7. Perform Exercises as Recommended
Perform any prescribed exercises, such as gentle hand and wrist movements, to maintain circulation and prevent stiffness. Elbow motion is allowed, but be careful not to move your shoulder unless instructed it is ok.
Do not attempt shoulder or arm movements until cleared by your doctor.
8. Keep the Sling Clean
Regularly check the sling for cleanliness, especially if it becomes sweaty or dirty.
You may need to hand-wash it according to the manufacturer's instructions.
Some patients elect to purchase a second sling to use while washing/drying the main sling.
9. Sleep with the Sling
Sleep with the sling on, as instructed by your doctor, to protect your shoulder and prevent accidental movement during sleep.
Use pillows to support your arm and keep it in a comfortable position.
10. Watch for Signs of Complications
Be aware of signs like increased pain, swelling, numbness, or tingling in your arm, which may indicate the sling is too tight or not positioned correctly.
Contact your healthcare provider if you notice these symptoms or if you experience any unusual discomfort.
Breg: Slingshot 2 Shoulder Brace
Slingshot 2 Shoulder Brace
Breg: Slingshot 3 Shoulder Brace
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