American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

How Can I Be “Strong for Surgery?”

Every year, 15 million Americans have some kind of surgery. If you are going to have surgery, it is important to learn about the potential risks you might face, and what you can do to prepare so that you have the best possible results. You have an important role in your recovery.

Strong for Surgery is a program that works with surgeons and hospitals to provide tools like checklists that surgeons can use to assess your risks in four target areas: nutrition, blood sugar control, smoking cessation, and medications. You can lower your risk by being better prepared for your operation.

Strong for Surgery has developed tools and resources for patients facing surgery that are available here on the website. We suggest that you use them when you talk with your doctor. Bring copies of the checklists along to your visit and ask your doctor if any of these things would be helpful for you:

Eat Well

It is important to eat healthy foods before your operation. Tell your surgeon if you have trouble eating or if you have not been very hungry. Also tell your surgeon if you have lost weight without trying or cannot eat at all. Your surgeon may want you to see a dietitian, who can help you work out an eating plan. A lab test called an “albumin” level may be ordered to see if you are at extra risk for problems after your operation because of your nutrition or for other reasons.

Quit Smoking

Smoking increases the risk for many problems after your operation. It can:

  • Make it hard for you to breathe
  • Make an infection in your wound (incision) more likely
  • Increase your chance of having a heart attack

Ask your surgeon about how to quit smoking. Quitting will not only reduce these risks, it will also improve your overall health and even add years to your life.

Blood Sugar

If you have diabetes, you know how important good blood sugar control is. Your surgeon needs to know what your recent blood sugar test results have been. On the day of your operation, your surgeon should check your blood sugar before your operation. Having an operation puts stress on your body, and stress can affect your blood sugar level. Blood sugar that is too high or too low can cause serious problems. Keeping blood sugar in control before, during, and after your operation will reduce your risk of infection in your incision and will help you heal better.

Even if you haven’t been told you have diabetes, your doctor may want to check your blood sugar. Many people have high blood sugar and don’t know it.


Your doctor needs to know what medicines, over-the-counter drugs and supplements, and herbal remedies you are taking. Some of these can increase your risk of bleeding. Your surgeon will tell you which ones to stop taking—and when to stop them—before your operation.

Some medicines should not be stopped. If you are taking one of these, your surgeon will make sure the hospital staff knows so that you get the right medicines before and after your operation.


Preparing for Surgery