ERAS® PROTOCOLS
BEFORE SURGERY
- Mental and Emotional Preparation
- Smoking Cessation
- Nutrition
- Alcohol Use
- Skin Preparation
ERAS® PROTOCOLS
AFTER SURGERY
- Nutrition
- Hydration
- Activity
- Pain Management
- Skin Management
- Scar Management
ERAS® PROTOCOLS BEFORE SURGERY
Enhanced recovery begins long before a surgical procedure takes place. The better physical and mental shape you’re in before surgery, the easier and faster your recovery will be. Dr. Wiser uses ERAS® guidelines to provide patients with the knowledge and tools they need to reach their healthiest state before surgery. Before the day of the procedure, Dr. Wiser and his team will talk to you about your role in the enhanced recovery pathway and give you important details about how to prepare your body for surgery. This includes protocols regarding:
Mental and Emotional Preparation
Psychological stress can slow recovery after surgery. At WiserMD, we prioritize patient education to reduce fear and help you feel prepared, ensuring a smoother healing process.
Skin Prepration
A surgical site infection (SSI) can occur during or after surgery, ranging from superficial skin layers to deeper tissues or implants. Bathing with antibacterial soap before and after surgery significantly reduces this risk. At WiserMD, we provide chlorhexidine-based soap, proven to prevent post-surgical infections.
Smoking Cessation
Smoking before or after surgery greatly increases risks like poor wound healing, infection, and complications. At WiserMD, patients must be smoke-free for at least four weeks and pass a nicotine test before surgery. Need help quitting? Our team offers resources and support.
Alcohol Use
Alcohol and anesthesia don’t mix. Drinking before surgery can cause complications like excessive bleeding, delayed healing, and immune issues. Avoid alcohol before your procedure for a smoother recovery and better results.
Nutrition
At WiserMD, we assess your nutritional status before surgery to address deficiencies with tailored dietary changes and supplements.
Key nutrients for recovery include:
-
Iron: Prevents anemia by maintaining healthy red blood cells.
-
Vitamin C: Boosts immunity and aids wound healing.
-
Vitamin D: Supports wound healing.
-
Protein: Builds and repairs tissues.
-
Omega-3s: Reduce inflammation and enhance immune response.
-
Amino Acids: Accelerate recovery and manage physical stress.
We may also recommend immunonutrition formulas or isotonic drinks to optimize hydration, reduce inflammation, and support healing.
ERAS® PROTOCOLS DURING SURGERY
During surgery, the ERAS® guidelines focus on multi-modal approach to pain management and the treatment of postoperative nausea and vomiting. Your first dose of medicines to treat these concerns will be administered prior to the start of surgery. During the procedure, you will be watched over by a team of specialists who will monitor your state to ensure you remain safe and comfortable.
Nausea Management
Nausea and vomiting are common risks of anesthesia, causing discomfort and slowing recovery. To reduce these effects, we provide anti-nausea medication before and during surgery.
Pain Management
Surgery often comes with some discomfort, but ERAS® care plans minimize side effects of pain medications, helping you recover faster. Your personalized plan may include a regional nerve block with Exparel®, which numbs the surgical area for up to 72 hours, and gabapentin, which increases pain tolerance and aids recovery. Starting certain pain medications before surgery reduces the need for anesthesia and narcotics afterward.
Surgical Techniques
Scarring is a natural part of surgery, but Dr. Wiser uses advanced techniques and strategic incision placement to minimize their size and visibility. With careful suture selection and precise methods, he balances achieving your desired results with reducing scarring.
Hyperbaric Oxygen Therapy: Another Way to Recover After Surgery
Explore Hyperbaric Oxygen Therapy (HBOT) at WiserMD—an advanced method to support post-surgical recovery. HBOT accelerates tissue repair, reduces inflammation, and enhances overall healing. Discover how this expert-recommended therapy can be your next step toward optimal recovery.
ERAS® PROTOCOLS AFTER SURGERY
After your surgery, you will go to a recovery room where members of your WiserMD care team will monitor your vital signs as you wake from anesthesia. They will also give you any medicines you need and update your caregivers on how you are doing. It is important to get out of bed, sit in a chair and walk as soon as you are ready. Do this as often as you can. Your team will tell you when it is safe for you to start drinking, eat solid food, move without assistance and go home. Enhanced recovery protocols during the postoperative stage include:
Nutrition
Starting a nutrient-rich diet shortly after surgery improves healing and reduces infection risk. Focus on lean protein, antioxidants, vitamins, healthy fats, and fiber while avoiding added sugars, processed foods, and alcohol to minimize complications.
Hydration
Staying hydrated after surgery is crucial for recovery. Drinking water reduces nausea, prevents constipation, and boosts appetite. If plain water isn’t enough, isotonic drinks can help maintain hydration levels effectively.
Activity
ERAS® protocols reduce nausea, pain, and constipation, enabling earlier movement after surgery. Walking soon after surgery improves blood flow, breathing, and wound healing while reducing the risks of pain, constipation, infections, blood clots, and pneumonia.
Pain Management
Dr. Wiser carefully prescribes medications to manage pain, inflammation, and nausea after surgery. Using Exparel® during the procedure and a tailored combination of medications afterward, he minimizes the need for narcotics, reducing side effects like nausea and helping patients recover faster and return to daily life sooner.
Skin Management
The lymphatic system plays a key role in detoxifying the body and reducing swelling. After surgery, lymphatic massages help drain fluids, reduce pain, and speed up recovery. Recommended for procedures like liposuction or tummy tucks, WiserMD advises weekly massages to enhance healing and results.
Scar Management
Dr. Wiser uses advanced scar minimization techniques during surgery and provides guidance for at-home care. This includes proper washing, dressing, scar massage, and using silicone gels or sheets. He also recommends the PREVENA™ Incision Management System, which protects incisions, removes fluids, and promotes healing.
What Is Enhanced Recovery After Surgery?
ERAS® is a patient-centered, evidence-based treatment program designed to achieve early recovery for patients undergoing surgery. The protocol items are developed by medical professionals across multiple disciplines, including surgeons, nurses, anesthesiologists, dieticians, physical therapists and others. These professionals jointly monitor the latest research and best practice standards, and continuously update ERAS® guidelines to optimize patient outcomes.
ERAS® is a collection of complementary practices (or “pathways”) that work together to make recovery faster, easier and healthier. These practices are all about you — the patient — and making sure your surgical experience is the best it can be. Medical providers around the world are implementing ERAS® protocols to improve quality of care and increase patient satisfaction.
To enhance your recovery from surgery, you need to play an active role in your own care. You and your surgical team will work together to get you back to full health as quickly as possible.
The Benefits of Enhanced Recovery Protocols
ERAS® programs have been shown to be safer and more effective than traditional recovery care. Implementation of these protocols is associated with numerous benefits, including:
- Shorter length of hospital or surgery center stay
- Decreased postoperative nausea, vomiting and pain
- Decreased reliance on narcotic pain medication
- Lower complication and readmission rates
- More rapid return of bowel function
- Accelerated return of organ and musculoskeletal function
- Earlier resumption of normal activities
- Reduced fatigue and need for daytime sleep
- Reduced number of days patients require off work
For more information about how we approach recovery after plastic surgery, please don’t hesitate to contact us. We’d love to speak with you about our process and answer any questions you may have.