Postoperative Instructions:

Ankle + Foot Surgery Postoperative Instructions:

Congratulations, you are on the other side of surgery and on the road to healing.  The most important part of healing is controlling the swelling.  Less swelling, less pain, less scar tissue, better healing. The following acronym of P.R.H.I.C.E is what you need to remember.

Pain (medications and management):

The first three days will be the most important for resting and taking pain medications as directed.  This is the time when the pain is greater, and less is better for keeping this from escalating.  If you have a pain pump within the bandages below your knee, there is nothing you need to do.  It is automatic and will dispense the anesthetic every hour.  If you have a pain pump above your knee, installed by the anesthetist, then please refer to the instructional DVD (to be supplied by the hospital), or contact the anesthesia person directly. Both will be removed on your first visit.

If you are getting throbbing pain that is not relieved with the pain medication, you can increase the dosage of meds (2 instead of 1) or take them more frequently (every 4 hours), or loosen the brown bandage.   This is best done by cutting the brown bandage partially (cutting up from the toes toward the ankle), and or removing it all together. See the Compression section. 

Rest:

This will dramatically decrease your swelling, and more importantly allow your skin (and bone) to heal.  It is important to heal the skin as efficiently as possible.  Once the skin is healed you will be in a safer place in regards to infection, and have more freedom in regards to showering and rehabilitating your ankle and/or foot.  Rest should involve keeping your foot elevated above your hip.  Rest should also include being non-weight-bearing with crutches and only getting up for basic needs: bathroom and nutrition. 

Hygiene:

This is simply keeping your surgical bandage clean and dry. 

Ice:

Apply ice to your ankle (cryocuff or ice bags) three times a day for 60 minutes.  Applying ice to your ankle will cool down your whole foot and decrease swelling and pain.  Please remove the cryocuff between icing, in order to “air out” the foot.

Compression:

This is incorporated into the bandage that is applied in the O.R.  The brown bandage over the bandages is the compression bandage.  If this is removed to relieve the throbbing pain, this can easily be replaced with a loose ACE wrap.

Elevation:

Keep the foot and ankle above the hip with 2 pillows.  Being in a semi-reclined position will reduce blood pressure and swelling in the feet.

During the first week after postop all bandages, bracing, casting, and shoegear should be left on full-time (unless otherwise directed). 

Please do not hesitate to page me if there are any questions or complications: 603-543-9222.  At the tone enter the number you want me to call, followed by the pound (#) sign.  If there is no response to a page, please call my Mobile phone: 603-477-7575 or go to your local ED.

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Ingrown-Infected nail procedure (done in office)

Following the procedure the involved leg should be elevated for minimally 3 hours.  The great toe is very vascular, and these can become very bloody.  Soaking in epsom salts, atleast 3 hours afterwards, is recommended to draw out the infection.  Soaking should be done 15-20 minutes 1-3 times per day in lukewarm water.  This should be followed by application of an antibiotic ointment (neosporin or bacitracin) and a gauze bandage secured with tape.  Once the drainage and redness subsides (5-7 days) then soaking is no longer necessary, and the gauze-tape bandage can change over to a regular elastic cloth adhesive bandage strip (another 5-7 days).  If the redness, drainage, pain persist after the first week, please contact the office.  If you were started on an antibiotic before the procedure, please finish the prescription as directed.  If you repeatedly get infected nails, a permanent procedure can be done to prevent recurrence in the future.  Please see the Ingrown nail-Permanent Nail Removal section on the Deformities and Surgery page.