Post-Operative FAQs

 

Using Crutches - Discharge Instructions

Frequently asked questions regarding bandage care, swelling, pain management and mobility.

Bandage Care

How should I take care of my bandage?

  • The type of dressing you will have post-operatively depends on the type of surgery performed. On the day of surgery, you will receive specific verbal and written instructions about your dressing.
  • If you have a splint, you will not have to do anything. Occasionally, if you have a small dressing, you may be instructed on how to change it prior to your first post-operative appointment.
  • Regardless of the type of dressing, you should not get the incision wet before returning for your post-operative visit. This interferes with proper healing and may result in infection.

What should I do if there is blood on my bandage?

  • Drainage and bleeding after surgery is normal. You may notice blood or drainage on the dressing or splint. It is OK to place extra gauze over the dressing to reinforce it, but do not remove the entire dressing.
  • Elevating your leg above your heart can help slow down the bleeding.
  • If the dressing is saturated with wet blood after the first 24 hours, call the office (410-659-2800).

What should I do if I get my bandage or splint wet?

  • Please contact the office at 410-659-2800 to determine if an appointment is needed to change your bandage.

What are some signs and symptoms of infection?

  • Temperature above 101 degrees Fahrenheit
  • Foul smelling, purulent (containing pus) drainage
  • Body aches / chills
Bathing

How should I bathe or shower after my surgery?

  • You should not get your bandage or incision wet until after your first post-operative visit. This will interfere with proper healing and may result in infection.
  • You can take a bath with your operative leg hanging out of the bath tub to keep it dry.
  • Commercial cast or bandage protectors are available at medical supply stores or online. These covers can protect your bandage or splint from getting wet during a shower.
  • Another option to protect the bandage or splint during a shower is to use two layers of trash bags (NOT grocery store plastic bags) and duct tape above the knee.
  • If you are supposed to be non-weightbearing on your operative leg, you will need to sit on a chair or stool in the shower.
  • If you are allowed to weight bear on your operative leg, you can wear the commercial bandage protector or double plastic bags with duct tape over your boot and stand in the shower normally.
Avoiding Swelling / Elevating the Foot

What should I do about swelling?

  • Excessive swelling after surgery can make it difficult for the incision to heal properly and can increase the amount of pain that you experience. Therefore it is very important to do everything possible to decrease swelling during the 10-14 days following your surgery.
  • Leg elevation is the most effective way to control swelling after your surgery. When the leg is kept above your heart, the blood can drain more easily away from your foot and ankle which will decrease swelling. This will also help to decrease the pain and throbbing you feel in the leg following surgery.

How much should I elevate?

  • Elevation means:
    • Four or five pillows under the leg while you are in bed
    • Hanging the leg over the top of the backrest when you are lying on the sofa
    • Resting your foot on top of the table when you are sitting at a desk or the kitchen table

Should I use ice?

  • If you have a light bandage around your foot or ankle and not a hard plaster splint, ice can be helpful to decrease swelling.
  • You should not ice until after the nerve block is completely worn off because this could cause frostbite.
  • Once the nerve block has worn off you can use an ice pack on the foot or ankle for twenty minutes at a time every couple of hours. Do not get the bandage wet.
Avoiding Blood Clots

How can I avoid getting a blood clot after surgery?

  • A blood clot (Deep Venous Thrombosis or DVT) can be a serious complication after surgery. Your doctor will discuss with you if you have any risk factors for developing a blood clot and will decide if you need a blood thinner medication after your surgery.
  • It is very important to not sit or lie in one place for extended periods of time after surgery. This will put you at significant risk for developing a blood clot.
  • Every couple of hours during the daytime you should get up and move to another room to elevate your leg. It is recommended that you limit walking to moving between rooms (bathroom, kitchen, bedroom, TV room). Even when switching rooms, continue to elevate your leg once you sit or lie down.

What are the symptoms of a blood clot?

  • Symptoms of a blood clot include increased pain, swelling, or warmth in the calf or thigh, shortness of breath, chest pain, or palpitations. If you experience any of these symptoms you should call the doctor’s office or doctor on-call immediately.
  • Blood clots usually occur in the first few weeks following surgery, but can sometimes happen even several months after surgery as long as you are still immobilized in a boot or not walking normally.
Pain Management & Medications

How long should the nerve block last?

  • A nerve block is an injection administered during your surgery which will numb your foot or ankle after surgery. Some patients may wake up in the recovery room with pain despite having a nerve block.
  • While the nerve block is still working, you will be numb and may not be able to move your foot or ankle or wiggle your toes. This is normal.
  • Most nerve blocks will wear off sometime in the evening after surgery or early the next morning.
  • Sometimes a nerve block may last longer for up to two days. This is still normal and will not harm you or cause any long term side effects.

How do I manage my pain after surgery?

  • When the nerve block wears off, there will be a significant amount of pain that will not be able to be completely relieved with the pain medication.
  • This will last for 2-3 days, and then the pain level will begin to decrease appreciably for most patients.
  • TAKING YOUR PAIN MEDICATION – It is advisable to begin taking your prescribed pain medication before your nerve block wears off.
  • Preferably, start within a couple of hours after surgery and continue every 4 hours for the first 24-48 hours.
  • Make sure that you or your companion sets an alarm overnight to give you the pain medications on schedule. Our goal is to make you as comfortable as possible; however, you may still experience some pain.
  • After your pain begins to diminish (24-48 hours), begin to taper your medication by taking fewer pills or taking them less often, as needed.

What can I do for my nausea?

  • Nausea after surgery is common. It can be from the medications that the anesthesiologist gave you during the surgery and/or the narcotic pain medications that you use afterwards.
  • In order to avoid nausea, pain medication should not be taken on an empty stomach. You may have also been prescribed a medication for the prevention of nausea during your post-op course. This medication should be used as needed.
  • As soon as you are comfortable enough, discontinuing the narcotic medications will be the most helpful way to stop your nausea.

What can I do for my constipation?

  • Constipation is a side effect of the pain medication which can slow the functioning of your intestines. Senokot-S (over-the-counter) is recommended if needed while you are still using the narcotic medications.
  • Once you stop taking the pain medication, your bowel function should quickly return to normal.
  • Drinking plenty of fluids and eating fresh fruits and vegetables will also help.
Mobility

How do I get around after surgery?

  • After surgery, you may be non-weightbearing for a period of time, varying from a day or two to several months. The length of time will depend on the kind of surgery you had and the progress of your healing.
  • Non-weightbearing means that your foot may not touch the floor, even in a splint or boot. Any weight put on the healing bones or joints will adversely impact your recovery.
  • If your doctor recommends crutches or a walker, they will be provided, adjusted to your height and you will be instructed in the proper way to use them.
  • Instead of crutches or a walker, your doctor may recommend or you may prefer to use a Roll-a-Bout. This is a wheeled support for your leg that enables easier mobility than crutches. The Roll-a-Bout can be rented or purchased. You can contact the company at 888-736-6151 or www.roll-a-bout.com.