Post-Operation Care
Regardless of your performed procedure or surgery as an in-patient or a day-case, it will still have a significant impact on your activities of daily living and routine while you recover. Each procedure will have its own restrictions and challenges, and you will receive detailed instructions for the recovery of your specific procedure.
Post-Op Recovery Info
.jpg)
​If you are unable to reach anyone at the Practice or feel you have a medical emergency, please do not hesitate to go to the nearest urgent care or emergency department for further management.
First 24 hour precautions
-
Upon discharge, go directly home or to the place you are taken care of.
-
You MUST plan for a responsible adult to stay with you the first night following surgery.
-
WE STRONGLY DISCOURAGE USE OF ALCOHOL WITH PAIN MEDICATION DURING THE FIRST FEW DAYS
-
It is not unusual to feel lightheaded up to 24 hours after surgery or while taking pain medications. If you feel lightheaded, sit up for a few minutes before standing and have someone assist you when you get up to use the restroom.
-
Do not make any important or legal decisions for 24 hours or while on strict use of pain medication.
-
You may experience dry mouth, sore throat, or sleep disturbances from the anesthesia and medications used during surgery. Generalized muscle aches can sometimes occur. These symptoms generally disappear within 24 hours.
Pain Management
If you have received a nerve block/ pain block, the pain relief can last up to 72 hours post- surgery, this also means you may not have sensation or movement in your foot for that amount of time. You will have pain after the block wears off! Anticipate this and start pain medication prior to the block wearing off.
-
Take your first dose of the prescribed pain medication as soon as you get home, even if you have no pain. Continue to take your medication continuously as prescribed for the first 24-48 hours – ensure that the patient (you) is alert and have no difficulty breathing before taking the medication.
-
Often it may be helpful to set an alarm throughout the night to ensure you don’t miss a dose of the medication and wake up with a lot more pain.
-
You can expect that the first two nights will be the most painful and uncomfortable. You will receive prescribed medication to make you as comfortable as possible, but you may still have some break-through pain.
-
This is not unexpected, as the feet and ankles have a high density of nerve endings (originating from the sciatic nerve and its branches), enabling crucial sensory and motor functions for balance and movement. Due to these nerve endings patients state the pain from foot and ankle surgery is worse than a lot of other injuries or procedures!
-
After the first 72 hours, you may take the medication as needed for pain.
-
As your pain improves, you can gradually decrease your pain meds. You may also use these medications as directed early in the post-operative process to supplement the narcotic pain medication.
Dressings/ Backslab/ Cast
-
A bandage or below knee cast will be placed depending on procedure undertaken but will be discussed with you by your surgeon.
-
Bleeding through the dressings is quite common, especially with forefoot surgery and reconstruction surgery.
-
This usually occurs for the first 1-2 hours after surgery. The actual bleeding has stopped by the time you see the drainage through your dressings.
-
Post-operative bruising may develop on the operated leg, ankle, and foot. It is a normal occurrence due to tissue trauma and may be resolved within a few weeks. Bruises may initially appear dark, but as they heal, they can change color, becoming bluish, greenish, or yellowish.
-
In most cases, your first wound care dressing change will be performed at your first consultation follow-up visit (usually around 2 weeks post operative).
-
Please do not remove your dressings, backslab or cast.
-
Depending on your surgery, you may also receive a circular cast to replace the temporary cast (backslab) that was applied after your surgery.
-
If any problems arise, please contact the Practice for further management.
-
Your dressing/backslab/circular cast should always kept DRY – do not shower, bathe, or​ wet your dressing/backslab/cast in any way after surgery!
-
Dressing/Cast protectors and shower covers are available at the Practice or at Dischem pharmacies.
Examples and explanations
A safe way to sit in the shower with a cast protector over the backslab/ cast to keep it dry.
Don’t let the shower spray/ wet the cast.
If your shower allows an extra chair for leg elevation, it will be beneficial.
A full leg cast protector example.
Backslab example. Foot will be in a 90-degree angle (except in the case of Achilles surgery)
A backslab (By definition a Backslab is a plaster of splint that doesn’t completely cover a limb, only at the back side and secured with bandages circumferentially around the limb
A typical forefoot surgery post-operative wound cover in a fore-foot offloader shoe.
Full circular cast (a rigid cast made of fiber glass that encases the limb in a 360 degree layer)
A typical forefoot surgery post-operative wound cover in a fore-foot offloader shoe.
Full circular cast (a rigid cast made of fiber glass that encases the limb in a 360 degree layer)
Wound Care/ Stitches
-
Post-operative care and wound care play a vital role in the healing process for the best possible outcome and decrease wound care risks and complications.
-
Absorbable subcuticular stitches (Dissolvable stitches) are used for most cases.
-
If any nylon stitches/ sutures are used these will be removed at your 2-week follow-up or even between 3 to 4 weeks depending on the site of the incision.
-
The wounds and dressings must always stay dry and in place.
-
​Once your stitches are removed and the wounds are fully healed you can wash the foot/leg with soapy water and gently cleanse and dry the area. Do not soak the incision(s) in a bathtub or hot tub until the incision(s) is completely healed.
-
Comprehensive education will be given on follow-up appointments as to your specific wound care needs.
Examples and explanations
Toes above the nose. Foot/ leg elevation above the level of the heart.
Please observe that there is no pressure under the heel area.
Elevation/ Swelling management
-
Strict elevation of your foot/ leg above the level of your heart for the first two weeks after surgery. Elevation of the foot remains important to limit swelling and help wound healing.
-
“Toes above your nose” elevation.
-
The more you elevate your foot and ankle, the less pain you will have.
-
In the first 2 weeks/ first few days following surgery, restrict the time your foot is “down” to 10 minutes or less at a time.
-
It is also good to keep your blood flowing through the operated leg and limit the risk of blood clots.
-
After the strict elevation period (2 weeks) is completed, you may gradually become more active. You should “listen” to your foot/ ankle as to when to get off the foot it and elevate it again.
-
This may help even, months after surgery.
-
Compression socks may also be suggested for the management of swollen feet.
_edited.jpg)
Thromboprophylaxis
-
Foot and ankle surgery can have an increased risk for deep vein thrombosis and pulmonary embolism, especially in cases where cast application and non-weight bearing are required.
-
More details around this will be given to you by your surgeon.
-
If you are in a backslab/ circular cast, thromboprophylaxis (a blood thinner) will be prescribed for a duration of 4 - 8 weeks. This will reduce the risks of blood clots forming.
-
Please speak to your surgeon on any travelling and flying plans after surgery.
Vitamin D supplements
-
Vit D supplements will be prescribed in cases of osteotomies or arthrodesis. This has been shown to increase bone union and decrease complications significantly.
-
It plays a crucial role in bone healing, calcium absorption and overall recovery, potentially aiding in faster healing and reducing complications.
Pins and Needles
-
Pins and needles (tingling or numbness) after foot surgery can be a normal part of the healing process, but if they persist or worsen, or if accompanied by other concerning symptoms, it's important to seek medical advice.
​​
-
Here's a more detailed explanation:
Normal vs. Concerning:
Normal:
Temporary numbness or tingling can occur due to nerve irritation or swelling after surgery. It's often explained by the surgeon or healthcare provider before the procedure.
Concerning:
If the tingling or numbness is severe, it doesn’t improve, or is accompanied by:
-
Loss of movement or function
-
Severe pain
-
Burning sensation
-
Cool or pale foot or toes
-
Signs of infection: (increased pain, swelling, redness, warmth, pus, red streaks)
-
Persistent pain, that doesn't improve with elevation, ice, or medication
When to be concerned and what to do
-
The operated leg may swell and pain at home. But if the swelling and pain persists regardless of elevation, rest and pain medication contact the Practice for further management.
-
If the tingling or numbness is severe or does not improve contact the Practice for further management.
-
If your bandages/ backslab/ cast got soaking wet contact the Practice for further management.
-
Severe swelling and/ or pain in the calf: this could indicate deep vein thrombosis (DVT) (blood clot in leg) which requires urgent evaluation and treatment! Contact the Practice for further management.
-
Profuse bleeding: that soaks through your dressing and increases in size throughout the first day after surgery and discharge to home. Contact the Practice for further management.
-
Blue or white toes: this indicates a lack of blood flow to the foot, please contact the Practice for further management.
-
If you suspect signs of infection such as increased pain, swelling, redness, warmth, pus, red streaks and pyrexia (fever episodes) please notify the Practice.
-
If the bandages, backslab or circular cast feels too tight that it causes burning sensation, pins and needles, bluish toes that are cool and pale, pressure sores and pressure points, please contact the Practice for further management.