How long after foot/ankle surgery do I have to keep my leg elevated?
Wounds usually seal and stop bleeding by three days following surgery. We insist on strict elevation for 23 hours per day during this ‘sealing’ period. Afterwards, we recommend letting pain and swelling be your guide – if it hurts or feels swollen, elevate it.
When can I drive after foot/ankle surgery?
If you drive an automatic transmission, you may begin driving with your non-operative foot when you no longer require much narcotic pain medication and your three day elevation period is over. Remember, learning to drive with the left foot can be challenging but, with a little practice you can re-learn just like when you were 15 years old. If you drive a manual transmission or have surgery on both feet at the same time, don’t return to driving until you’ve healed adequately. This varies greatly with the procedure.
How long will it take to heal my wound (or how long until my stitches are removed)?
Wounds around the foot and ankle heal more slowly than other areas of the body. They generally heal in about 14 days. At Lance Silverman, MD, we only use absorbing stitches that create very little foreign body response. With these sutures the wounds are less painful, less red and swollen, and heal routinely. In wounds that do not have tension, Dr. Silverman uses a plastic surgery style closure with the stitches underneath the skin.
How long until I can bear weight (walk)?
Weight bearing varies from the day of surgery to weeks or even months after the operation. Your ability to weight bear depends entirely on the type of surgery and what you are trying to heal. Read more on why it’s important to stay non-weight bearing.
How long will I be in pain?
Every patient’s interpretation of pain is different and the level of pain is dependent on what surgery is performed. While all the pain/discomfort may take a few weeks to go away, the most intense post-surgical pain is concentrated in the first few days. If only soft tissue work is performed, the pain usually resolves significantly by three days after surgery. If surgery is done to one of the bones, the pain is more intense initially and may take five to seven days to reach a level of comfort that doesn’t require narcotics during the day. Pain that requires increasing doses of narcotics beyond this five to seven day period is a potential warning sign and should be investigated immediately.
How long will I need help at home?
That depends on how mobile you are within your limitations of the surgery. In all cases, you need help your first night after surgery when the nerve block wears off. It is scary to be in pain alone and no one should go through that without help. Having family or friends take a day off work or spend the night is invaluable. Once you can manage under your particular weight bearing restrictions and you have prepared for your surgery, you don’t need that help.
How long will I be out of work?
That depends on your job and how long it takes your particular surgery to heal. Most patients with sit down jobs can return as early as one week after surgery. Those with heavy labor jobs or jobs that require a lot of standing will have restrictions that prevent their safe return until complete healing.
Can I change my dressing?
Never change a dressing unless your doctor gives you permission. Dressings have many functions including keeping wounds clean, holding tissues in alignment, and controlling post operative swelling (edema).
Will I get a choice of cast colors?
Yes, but you need to specify which color you would like.
When can I get the wound wet?
We routinely let patients shower their wound once the special post-operative dressings have been removed. Usually this is anywhere from one to two weeks after surgery. We recommend avoiding soaking wounds until any portals into the skin (stitches and pins) have been removed. If your leg is under a cast you will need to keep it dry. Keeping the incision area wet will cause maceration and bigger problems during the first two weeks of wound healing.
What type of anesthesia should I expect?
(General vs. regional) Most patients have a combination of both. Regional anesthesia or nerve blocks provide phenomenal pain control both during and after the surgery. However, without some sedation, it is impossible to hold still and tolerate what would otherwise be boredom during the procedure. Sedation (light sleepiness) and general anesthesia accomplish these goals. You will work with the anesthesiologist to decide how deep to be (some procedures need a deeper sleep). Regional anesthesia also permits the sedation or general anesthesia to be much less.
Is anesthesia safe?
Anesthesia is very safe. Since 1985 when the Anesthesia Patient Safety Foundation was started, the rate of anesthesia related complications have plummeted. Standardization of techniques, checklists, and technologic improvements have contributed to this decline.
Why shouldn’t I eat or drink before surgery?
For 8 hours before surgery you should eat no solid food. Most people are nervous before surgery and their digestive tract slows food transport. Food remains in the stomach for longer. During the intubation portion of the procedure there is a period of time when the airway is a risk to damage from vomitting stomach contents. Diminishing the risk of that event with the very dangerous complications that follow are why no solid food is allowed. Clear liquids are generally okay up to 4 hours.
What should I do on the day of my surgery?
Relax as best as you can. Don’t eat or drink. Shower or wash the extremity with a Chlorhexidine body scrub (Hibiclens is one brand). It has been shown to decrease bacterial infections. Get to the surgery center with time to spare, but be prepared to wait with reading material or computers.
Will I have a scar? How can I prevent scarring?
All incisions leave scars. The goal is to have a flat, thin scar that pigments just like the surrounding skin. There are a number of ways to accomplish this, such as:
a) Strict adherence to good surgical technique
b) Diminished post-operative wound inflammation (using less reactive sutures, avoiding bacterial contamination, treating the infection quickly)
c) Minimizing wound tension by controlling the swelling in the immediate post-operative period with elevation and compression dressings
d) Application of silicone padding to flatten scars once sutures are removed
e) Moisturizing creams after skin healing
f) Avoiding all sun exposure during the first year as the scar remodels