Microsoft word - foot & ankle surgery patient info gt.doc
DR GEOFFREY TYMMS
Foot & Ankle Specialist
(03) 9890 0494
Instructions for Foot & Ankle surgery
The following general instructions apply to preparation for and recovery from foot and ankle surgery: PRE-OP
On the morning of surgery please shower and thoroughly wash your feet and
toes with soap (anti-bacterial if available) and water.
On the day of surgery do NOT take any Insulin or diabetes tablets unless otherwise
instructed. (If you are normally on Insulin please confirm with the rooms that we have this information). Aspirin and any blood thinners (e.g. warfarin, Plavix, Iscover) should have been stopped one week before surgery.
Otherwise please take your normal medications (e.g., blood pressure tablets) with a
Attend hospital at appropriate time (REMEMBER to bring your XRs/SCANS please)–
there may be some waiting time before your surgery but you need to arrive so that you can be checked in by the nursing staff and seen by the anaesthetist beforehand. Please bring a book, magazine or music in case of a moderate wait or delay. SURGERY:
Surgery will generally be done under general anaesthetic (or spinal anaesthetic). Sometimes toe/ forefoot surgery can be done under local anaesthetic with some light sedation.
Local anaesthetic will often be used as a block into your foot or lower leg to numb the
area for pain relief after surgery. This is inserted during or just before your surgery. It will usually last between 8 to 24 hours depending on type of ‘block’. It will give either partial of full pain relief, after this regular painkillers are required.
Regular Paracetamol (Panadol) together with Endone (oxycodone) +/- Oxycontin (slow
release Endone) are usually prescribed. These should be taken regularly for the first 48-72hours and then ‘weaned’ off to just Panadol +/- Endone when required as the pain settles.
Possible side effects of the strong painkillers can include drowsiness, nausea and
Please leave your bandages intact until reviewed by your surgeon at the post-
operative visit (except for ankle scopes and plantar fascia release where the outer bandage can be removed after 2 days). A plastic garbage/kitchen bag sealed with tape and elastic band +-‘glad wrap’ is needed to keep it dry in the shower or bath. If there is excessive bleeding leaking through the bandage or the bandages get wet please contact the rooms and this can easily be re-bandaged if required.
Rest and elevation of your foot (above the level of your heart- ‘toe to nose’) is required
for the first 10 days following surgery. This helps minimise swelling and aids healing of your wounds. Icing of the area (if possible) for 20 mins 2-3 times per day for the first 3-5 days can also help reduce swelling and pain.
Gentle leg, ankle, foot and toe movement and stretching (if possible and not in plaster)
every hour will help with circulation and muscle recovery.
If you have been instructed to be ‘non-weight bearing’ this is to allow best healing of
bones/tendons/ligaments. Failure to comply may jeopardise the results of your surgery.
Time off work and recovery will depend on the nature of your surgery.
Generally a minimum of one to two weeks is required off for seated/ desk work (unless very minor surgery). For more prolonged standing or walking this will often require at least 4-6 weeks(or longer).
A ’post-op’ appointment will be made 2 weeks after surgery for removal of stitches
and to check the healing of your wounds. The next follow up will usually be a further 4-6 weeks later to check further recovery.
If physiotherapy is required this will be arranged/ discussed at your follow up
Complications are usually rare but can occur despite our best efforts to avoid them.
Most of them are minor and are easily remedied.
Complications relevant to your surgery will have been discussed with you, these can
Anaesthetic complications (eg, heart attack, stroke, nausea and vomiting)
Deep vein thrombosis(DVT) – blood clots
Recurrence of pain / deformity / instability
Non-union of bones (failure of bones to heal together)
Risks of infection and healing problems are much higher if you smoke or are diabetic. If you are able to give up smoking before and for a few weeks after your surgery this will help your healing process.
After surgery you should notify your surgeon / GP / Emergency department if you have any of the following:
Increasing pain (despite painkillers, rest elevation and icing)
Increasing swelling (despite rest and elevation above the level of your heart)
Discharge or increasing redness of your wound
Persistent numbness (greater than 48hrs after surgery)
For most surgeries it takes a minimum of 3 months to be recovering reasonably well (75%) , 6 months until 90% recovered and 12 months until complete recovery. Swelling is normal for the first 3-4months and can take 6-12 months to be fully recovered.
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