Comprehensive Surgical Preparation Protocol Comparison

A side-by-side analysis of preoperative assessment protocols — from standard medical workup through Enhanced Recovery After Surgery to the SHARP Method.

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Traditional

(baseline)

ERAS

Builds on Traditional + Adds

SHARP

Incorporates Traditional + ERAS + Adds

STANDARD PREOPERATIVE LABS

  • Complete Blood Count (CBC)
  • Comprehensive Metabolic Panel (CMP)
  • Coagulation Studies (PT/INR, PTT)
  • Urinalysis
  • Blood Type and Screen
  • HCG (pregnancy test if applicable)
  • Complete Blood Count (CBC)
  • Comprehensive Metabolic Panel (CMP)
  • Coagulation Studies (PT/INR, PTT)
  • Urinalysis
  • Blood Type and Screen
  • HCG (pregnancy test if applicable)
  • Hemoglobin A1c
  • Albumin / Prealbumin
  • Iron Studies
  • Complete Blood Count (CBC)
  • Comprehensive Metabolic Panel (CMP)
  • Coagulation Studies (PT/INR, PTT)
  • Urinalysis
  • Blood Type and Screen
  • HCG (pregnancy test if applicable)
  • Hemoglobin A1c
  • Albumin / Prealbumin
  • Iron Studies
  • hs-CRP (high-sensitivity C-reactive protein)
  • Vitamin D (25-OH)
  • Zinc, RBC Magnesium
  • Homocysteine
  • Omega-3 Index
  • Full Thyroid Panel (TSH, Free T3, Free T4, Anti-TPO)
  • Fasting Insulin

STANDARD IMAGING

  • Chest X-ray (if indicated by age/history)
  • EKG (if indicated by age/history)
  • Procedure-specific imaging as needed
  • Chest X-ray (if indicated by age/history)
  • EKG (if indicated by age/history)
  • Procedure-specific imaging as needed
  • Cardiac risk stratification (if indicated)
  • Functional capacity assessment
  • Chest X-ray (if indicated by age/history)
  • EKG (if indicated by age/history)
  • Procedure-specific imaging as needed
  • Cardiac risk stratification (if indicated)
  • Functional capacity assessment
  • Body composition analysis (where relevant)
  • Baseline photography and measurements

STANDARD HISTORY & PHYSICAL

  • Complete medical history
  • Surgical history
  • Medication reconciliation
  • Allergy documentation
  • Physical examination
  • Anesthesia risk assessment (ASA classification)
  • Complete medical history
  • Surgical history
  • Medication reconciliation
  • Allergy documentation
  • Physical examination
  • Anesthesia risk assessment (ASA classification)
  • Nutritional status screening
  • Functional status assessment
  • Smoking/alcohol cessation counseling
  • Patient education and expectation setting
  • Complete medical history
  • Surgical history
  • Medication reconciliation
  • Allergy documentation
  • Physical examination
  • Anesthesia risk assessment (ASA classification)
  • Nutritional status screening
  • Functional status assessment
  • Smoking/alcohol cessation counseling
  • Patient education and expectation setting
  • Detailed supplement audit with timing protocol
  • Inflammatory history and symptom assessment
  • Gut health and microbiome history
  • Sleep quality assessment
  • Stress and HPA axis evaluation
  • Genetic/genomic history (family patterns)

ERAS-SPECIFIC ADDITIONS

Not included in Traditional protocol

  • Preoperative carbohydrate loading protocol
  • Multimodal analgesia planning
  • Early mobilization protocol
  • Nausea/vomiting prophylaxis plan
  • Fluid optimization strategy
  • Venous thromboembolism prophylaxis
  • Surgical site infection bundle
  • Goal-directed fluid therapy
  • Preoperative carbohydrate loading protocol
  • Multimodal analgesia planning
  • Early mobilization protocol
  • Nausea/vomiting prophylaxis plan
  • Fluid optimization strategy
  • Venous thromboembolism prophylaxis
  • Surgical site infection bundle
  • Goal-directed fluid therapy

SHARP-SPECIFIC ADDITIONS

Not included in Traditional protocol

Not included in ERAS protocol

  • Genetic pathway assessment (CYP450, MTHFR, COMT, detox genes)
  • Personalized supplement protocol with surgical timing
  • Gut microbiome evaluation and restoration
  • Inflammatory burden reduction protocol
  • Liver detoxification support (Phase I & II)
  • Hyperbaric oxygen therapy (where indicated)
  • Red light / photobiomodulation therapy
  • Lymphatic support protocol
  • Hormonal optimization assessment
  • Post-operative immune monitoring
  • Two-track recovery protocol (surgical + systemic)
  • 12-month structured recovery timeline

Take the Next Step with the SHARP Method

You've seen how SHARP goes beyond traditional and ERAS protocols. Choose your starting point.

FREE

The SHARP Method — Free Chapter

Download a free chapter from Dr. Whitfield's book on surgical preparation and recovery. Covers the science behind the SHARP Method.

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SHARP Mini Course

Taught by Dr. Whitfield. A focused course on the SHARP Method — understand the protocol before committing to anything clinical.

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The SHARP Method Book

The complete framework by Dr. Robert Whitfield. The deep dive into surgical preparation, recovery optimization, and the science behind SHARP.

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