Pre-operative instructions for foot surgery patients

You have been given an operation date for foot surgery and should be contacted by the day surgery unit with a confirmation of the appointment and directions. If you have not received this within two weeks of the operation, please contact Mr Prior.

If you are covered by medical insurance, you should inform them of the proposed date and hospital prior to the operation. They will normally provide a pre-authorisation number. They may require the proposed operation(s) and code(s).

Please notify Mr Prior if you cannot attend so that another patient can be booked in your place.

On rare occasions it is necessary to cancel appointments. This can occur at the time of surgery if a previous operation has taken longer than expected. Every effort is made to avoid this and provide as much notice as possible.

In order to reduce the pain following surgery, you will require pain killers. You should get these before the operation and bring them with you to the operation. Some patients require additional drugs (e.g. antibiotics).

If you require a prescription from your GP please arrange an appointment one week prior to surgery.

Prior to surgery

• Ensure that you have someone to collect you after surgery and to stay with you for the first 4 days.
• Wash your foot (feet) daily with betadine surgical scrub (unless you have an allergy to iodine) or skin cleanser for 5 minutes each morning and night 3 days prior to surgery.
• Cut your toenails and clean under the nails well the day before surgery. Remove all nail polish.
• Do not eat for 1 hour before surgery.
• Wear loose clothing as a large dressing will be applied after the operation.
• Make sure you inform the podiatrist if you have an allergy to any medication or if your medication has been changed.

Your operation will be performed under a local anaesthetic in the operating theatre. When you arrive on the unit a nurse will change you into a theatre gown. The local anaesthetic will then be administered by one of the podiatry team before you are taken into theatre so that it has time to take effect.

During surgery

Before your operation starts, a tourniquet will be applied to your lower leg. This will be inflated so as to minimise bleeding throughout the operation. It is normal for this to feel quite tight.

Your blood pressure and heart rate is routinely monitored throughout the operation.

During the procedure, towels ensure that you are unable to see anything and you may bring something to read or a Walkman to listen to if you wish.

After surgery

On leaving theatre you will be transferred to the step-down area where you will have to remain on the theatre trolley with your foot elevated for 30 minutes. You will then be discharged home with your escort.

You will have a large bandage on your foot, therefore you will be given a special shoe. You will be provided with crutches if these are necessary.

• You will not be able to drive after your operation so make sure you arrange for a lift home and someone to accompany you.
• You will not be able to walk on your foot for at least 2-4 days after the operation. Make sure you have adequate help at home for this period.
• Ensure that you have pain killers, follow the instructions on the packet and do not exceed the recommended dose.
• Your operation may require a screw or pin being inserted into your foot. In some instances, this may be left sticking out of the foot. Whilst this will be covered by a dressing, extra care is required to avoid any damage.
• Generally, the pins and screws are left in place (other than those that are left sticking out). However, these sometimes move or become prominent when the swelling reduces and this often occurs many months after the operation. If this is the case they need to be removed and you should contact our department immediately. It is therefore advisable to keep the contact telephone numbers.

If you have any questions or problems, please contact Mr Prior on 0208 502 1777