A guide for patients following day case podiatric surgery

Following your procedure it is reasonable to expect a degree of pain or discomfort. The following instructions are for your benefit to help minimise swelling and pain.

Please read and follow carefully the advice given.

After your operation

You will need to go directly home after your operation, sit in the back of the car with your foot raised across the back seat.

Once home, you must rest for at least 24 hours on a bed or sofa with your foot raised to hip level and supported. A pillow or cushion placed under your knee may be more comfortable. Do not sit with your foot down or your legs crossed, as this will cause your foot to swell and become painful.

No walking is permitted (except to the toilet) within the first 24 hours. This is important to help reduce pain and swelling.

While you are resting with your leg raised, frequently bend your leg and ankle to help stimulate your circulation; this will reduce the risk of thrombosis and/or blood clot. It is important that you do not become dehydrated after your surgery, you need to drink plenty of fluids before and after your surgery. Avoid alcohol.

As the local anaesthetic begins to wear off you may experience some discomfort. Take your painkillers as directed but do not exceed the maximum dose. You should continue taking them for at least the first three days following your operation. This will considerably reduce the likelihood of suffering undue post-operative pain. Pain varies with operations and it is normal to have pain for the first three days. It should begin to improve by the third day. However, if you experience severe pain or are concerned, please contact the podiatric surgery department.

Ice packs may be placed at the front of the ankle over the bandage for 10 minutes (no longer). This may be repeated every hour to help reduce excessive discomfort and swelling. You might notice a small amount of blood on the bandage; this is normal. However, if the bandage becomes excessively stained with blood, it will need to be changed so please contact the podiatric surgery department.

Always wear your post-operative shoe when walking to protect your foot.

Two days after surgery

You may move around the house for a few minutes every hour, resting with your foot and leg raised afterwards. If your foot starts to become more painful, you are overdoing it and you must return to resting again. Walking may be gradually increased on the following days but it is important that you do not stand for long periods. Continue to rest and raise your foot after walking.

Do not disturb or remove your dressing and keep it clean and dry. If the bandage appears to be slipping off apply a little additional adhesive tape to keep it in place. Please avoid showers or baths unless a limbo or equivalent dressing protector is used. Do not try to attempt this with plastic bags wrapped around the foot. If you get the dressing wet, you risk introducing an infection into the wound. Should this happen please contact the department for a dressing change as soon as possible.

You will be given an appointment at seven or 14 days depending on the podiatric surgeon’s instructions.

After seven days

Please continue to keep the wound dressing clean and dry. You may be given an appointment seven days after your surgery to redress the wound. It is important that you attend this appointment to ensure the wound is healing normally. You will then be given further advice on how to manage your foot.

After 14 days

The stitches are removed (or trimmed if absorbable stitches are used) after fourteen days and the skin has usually healed at this stage. With certain procedures the stiches may need to remain in place longer. After some operations you may be able to return to wearing normal footwear. However, this is not always the case and you will be advised at your dressing appointment.

After four weeks

Four to six weeks after surgery, your foot should be more comfortable and begin returning to normal. Depending on the type of operation, you should be able to wear a lace-up running trainer. There may be some swelling, particularly towards the end of the day. This is normal and to be expected as feet and legs are more prone to swelling.

Your recovery time is dictated by the procedure you have had undertaken and it is advisable to re-read the information sheet about your operation.

After six months

The residual swelling should be slight, if not completely resolved and the scar line beginning to fade. However, you will continue to heal for up to 12 months after surgery.

Returning to work

Ask your podiatric surgeon about the most suitable time to return to work, as this varies depending on the type of procedure you have had and the nature of your job.

Emergencies

Please go directly to accident and emergency (A&E) if you experience any of the following:

• You develop severe pain, swelling or redness in your calf
• You develop pain away from the site of surgery (for example, in the calf or chest)
• You develop flu-like symptoms (for example, high temperature, lethargy etc)

If you have any other urgent problem out of hours you will either need to contact the out of hours GP service or phone NHS 111 for advice.
If you are unsure what to do or where to go in a non-emergency situation, you can phone 111. This is a free NHS helpline open 24 hours a day.