Preparing for Foot and Ankle Surgery
We want to minimise unnecessary stress and worry around your surgery. Correct and timely preparation will allow a smooth process. Below is a general guide as to what to expect around your surgery. Dr Workman will tailor your individual treatment plan, but if you have any further questions or require clarification on certain points, please contact us to discuss this.
Before surgery:
Dr Workman will discuss your surgery and hospital stay with you in detail prior to finalising dates and times of admission.
Please disclose all medications that you are taking, particularly herbal supplements, steroids, anti-inflammatories, blood thinners, rheumatoid drugs, contraceptives, and hormone replacement therapy. These medications can be linked with a higher risk of a blood clot or post-operative bleeding. Unless otherwise discussed, continue your usual daily medications, such as anti-hypertensive and diabetic medications as usual.
It is necessary to stop any smoking and the use of nicotine products prior to surgery. Use of even 1-2 cigarettes per day is linked to reduced bone and soft tissue healing and a high risk of infection and bone non-union.
You may require investigations such as blood tests, a chest x-ray, or an ECG, depending on your general medical health. This will be discussed between Dr Workman and the anaesthetist and, if necessary, a review with a physician will be scheduled.
Please inform us if you develop any local wounds, infections or significant swelling leading up to your surgery. This may require review and treatment or postponement of surgery to minimise infection risk.
Pack a bag that includes:
Pyjamas
Toiletries
Daily medications
ID document
Medical aid card
A loose pair of pants or shorts that will fit over a plaster cast/postoperative shoe/boot.
Confirm your next of kin contact details so that Dr Workman can phone post-operatively to confirm completion of your surgery and transfer to the ward.
Please complete the SEFAS satisfaction score before surgery: https://paperless.mobiletheatre.net/Dr-Workman-SEFAS
This allows us to track your progress and recovery, ensuring optimal outcome.
On the day of surgery
Do not eat or drink for 6 hours prior to your booked surgery time. You may drink clear fluid (water) up until 2 hours before surgery.
Do not shave your leg on the day of surgery. This can lead to micro abrasions/cuts and increase infection risk.
Shower/wash as normal.
Arrive at the hospital at least 2 hours prior to surgery and report to the main reception. You will need to bring your authorisation number, medical aid card and proof of ID. Your file will be waiting for you.
You will be taken to the ward where the nursing sisters will prepare you for theatre. You will also be examined by the anaesthetist who will be managing your case. The anaesthetic team Dr Workman works with are particularly experienced in managing foot and ankle surgeries. They will help to provide the correct pain management, as it is an essential aspect of surgery and recovery. This will usually comprise a general anaesthetic with local nerve block to minimise pain during and after the procedure. The anaesthetist will also provide a post-operative medication script. These medications should be taken as soon as discomfort is felt. With an active, pre-emptive approach to pain management, discomfort will be well-controlled. Often high dose vitamin D and a blood thinner, such as Xarelto, are included on your discharge medication.
The side on which surgery is to be performed will be clearly marked with a marking pen.
You will be taken through to theatre. Here you will move from the waiting area, to theatre, to recovery and finally back to the ward. This entire process adds 2-3 hours to the actual surgery time.
After surgery, you will be transferred back to the ward. If your case is done as a day case, once you have eaten, been to the bathroom and mobilised with the physiotherapist as needed, the ward staff will discharge you. You will not be able to drive and will require someone to drive you home.
If you are staying overnight, the nursing sisters will ensure that you are comfortable. It is recommended that you remain in bed, with the operated leg up on a pillow. Ask for any assistance if you require the bathroom. Pain medications should be taken as prescribed to keep any discomfort well under control. An x-ray may be performed, and the physiotherapist will help you mobilise. Once coping, you will be discharged home with a follow up date. You will not be able to drive and will require someone to drive you home.
After surgery
Dr Workman will discuss the specific post-operative protocol for your surgery. It is particularly important in the first 14 days post-surgery is that you elevate the leg and minimise the amount of time it is dependent. Allowing swelling to settle minimises discomfort and is essential for wound healing.
You will find that swelling and discomfort settle as you rest the limb and that you require less pain medications. If pain or swelling persist despite rest and the correct pain medications, please contact us.
Do not change or remove dressings. These need to remain in place and will be changed as necessary at your follow up visits. It is important to keep them clean and dry. You may experience some ooze from the wound, which is normal. If this persists, please contact us.
Foot and ankle surgery often requires the use of crutches or a walking frame to protect the limb while mobilising. Please also speak to us about the use of a scooter. These will be provided prior to discharge. This has a significant impact on daily activities – making (and carrying) a cup of coffee or moving in restricted spaces can be very challenging!
It is important to prepare your home environment for your return:
– If possible, avoid stair use initially.
– A plastic garden chair in the shower makes showering easier.
– Pharmacies such as Dischem and Wynberg Pharmacy stock rubber-sealed plastic bags to protect the leg and keep it dry whilst washing.
– Driving will not be possible until the limb has recovered sufficiently from the surgery
– Stock the fridge and consider premade/frozen meals for the initial post-operative period
– Preferably stay with someone or have someone stay with you for the first 2-3 days.
Return to work post-surgery is dependent on the surgery performed and your occupation. This will be discussed prior to surgery.
Follow up
Your first post-operative visit is usually 1-week post-surgery. This is a clinical check and discussion to ensure you are coping and rule out any obvious concerns.
The following visit, 2 weeks post-surgery, is to check the wound, remove sutures and apply a plaster cast if required.
A visit at 6 weeks post-surgery is to remove the cast and perform x-rays.
Further treatment is dependent on the individual surgery performed.
Follow up visits are generally not charged for and are included in the surgical cost. However, if required, consumables such as dressings and plaster cast material, are billed at cost.
Contact us
Please do not hesitate to contact us with any further questions or for further details:
Tel: 021 180 3218
WhatsApp: 076 839 9805
Email: [email protected]