ERAS

ERAS is Enhanced Recovery After Surgery and is a philosophy and program implemented at the Reddy Aesthetic Institute in order to promote rapid recovery from a surgical procedures.

The ERAS program starts well before any contemplated surgery and begins with a complete evaluation of one’s fitness to undergo surgery.  Clients are provided with detailed counseling on the importance of engaging in exercise as well as smoking and alcohol cessation before surgery.  Since I expect all my patients to walk independently after surgery, I have found that pre-operative physical conditioning is helpful.

Detailed discussions regarding nutritional enhancement occur before surgery.  I make the analogy that the stress of surgery is similar to running a marathon resulting in a Catabolic State.  Therefore, I encourage clients to adhere to a nutrient dense protein rich diet.  The day before surgery, I recommend adding complex carbohydrates to the diet.  The night before surgery, I recommend a 100 g carbohydrate drink, such as Gatorade.

A simple pre-surgical measure that we encourage is the use of Hibiclens soap to shower the night before surgery.

The ERAS program continues during surgery with measures to minimize fluid requirements during surgery; maintenance of appropriate core temperature; atraumatic tissue handling; minimizing the use of drains; and decreasing the occurrence of Post-operative Nausea (PONV).

Following surgery, we encourage early independent walking.  Additionally, measures to minimize any post-operative discomfort and nausea are continued.   An appropriate nutrition program rich in nutrients and protein is essential to proper healing and continued following surgery.   A yogurt with live cultures is helpful if you have been prescribed an oral anti-biotic.  In cases where drains are used, these are removed as soon as safely possible.

Enhanced Recovery After Surgery is proven to improve recovery after surgery and improve patient comfort.  You will be counseled on this approach prior to surgery at the Reddy Aesthetic Institute.  Please see the table below for a summary of ERAS.

Enhanced Recovery After Surgery (ERAS) Summary

Before Surgery

• Complete Medical Evaluation at RAI
• Anesthesia Phone Assessment
• Physical Conditioning
• Optimizing Nutrition
• Smoking & Alcohol Cessation

Night Before Surgery

• 10 g Carbohydrate Drink
• Hibiclens Shower

Surgery

• Goal directed fluid therapy
• Patient warming
• Minimizing tissue trauma
• Minimal use of drains
• PONV

After Surgery

• Early Ambulation
• Optimizing Nutrition
• Appropriate Opioid Use
• Optimal Patient Positioning
• Early Post-op Checks at RAI
• Drains, if present, removed as soon as possible.