Risks Of Noncompliance With Preop Instructions

Before undergoing a surgical procedure, patients are given preoperative instructions by their healthcare providers. These instructions are critical to ensuring a successful outcome of the procedure. However, Richard Birkett MD notes that many patients do not take these instructions seriously, which can lead to complications, extended recovery time, and even death in some cases. As a healthcare provider, educating patients on the risks of noncompliance with preop instructions is essential to ensure the best possible outcome for their surgical procedure.

1. Increased Risk Of Infection

One of the most significant risks of not complying with preop instructions is the increased risk of infection. Preop instructions usually include showering with an antiseptic soap the night before surgery and not eating or drinking anything for a specified time before the procedure. These are implemented to reduce the number of bacteria in the body before the procedure. Failure to do so can lead to an increased risk of infection, which can further prolong the recovery period.

2. Delayed Healing

Another risk of noncompliance with preop instructions is delayed healing. Physical activity restrictions and wound care instructions are provided to patients to help promote healing. These things help to prevent further injury or damage to the surgical site, allowing the body to heal correctly.

3. Adverse Reactions

Many patients may not take preop instructions seriously and continue to take medications without informing their healthcare providers. This can lead to adverse reactions to anesthesia or other medicines used during the procedure. Following instructions about which drugs can be taken before and after the procedure is essential to prevent adverse reactions.

4. Anesthesia Risks

Noncompliance with preop instructions can also increase the risks of anesthesia. This may lead to complications during or after surgery, including cardiac arrest, lung infections, and blood clots. Compliance with preop instructions is necessary to ensure precautions are taken to avoid adverse reactions.

5. Increased Time in the Hospital And Higher Costs

Not following preop instructions can extend the recovery time and lead to increased time in the hospital. This increases the risk of developing hospital-acquired infections, further complicating the patient’s recovery.

6. Death

The most severe complication of noncompliance is death, particularly in more complex surgeries. Failure to follow the necessary instructions can lead to postoperative complications that could be fatal, such as organ failure or infection.

7. Compromised Results

Moreover, the desired results may not be achieved. This can occur if the patient fails to follow instructions for wound care or physical activity restrictions, leading to impaired healing and a decreased procedure outcome.

8. Loss of Trust

Noncompliance can also lead to a breakdown in trust between the patient and the doctor. Patients need to trust their healthcare provider to follow through on any given instructions or advice. When patients fail to comply, it can cause a strain on this relationship and lead to future difficulties.

9. Higher Costs

Noncompliance with preop instructions may also come with additional costs. The patient often shoulders this. The additional costs are needed to cover extra care, monitoring, and possibly additional surgeries.

10. Surgical Complications

If you are told to fast before surgery, do so. This will prevent the likelihood of vomiting and aspiration during anesthesia induction. Not heeding the advice can lead to severe lung damage, infection, and prolonged hospitalization.

11. Wound Dehiscence

Not following simple instructions from the medical team, such as taking necessary precautions while coughing and sneezing, can cause the surgical wound to open up. This, in turn, can lead to infections, delayed recovery, and additional surgery.

12. Medication Complications

Patients who fail to disclose their medication history and do not follow the instructions about medication use before surgery may experience adverse effects, such as excessive bleeding or drug interactions that can cause complications during the surgical procedure.


Richard Birkett MD says compliance with preop instructions is essential for a successful surgical outcome. Patients should be educated on the importance of following these instructions to avoid potential complications and decrease recovery time. As healthcare providers, we must communicate the importance of compliance to our patients and ensure they understand the potential risks of noncompliance. By doing so, we can help ensure the best possible outcome for our patients’ surgical procedures.


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