Surgical Instructions

 

This page is provided as a resource for our surgical patients.

It is extremely important to follow our post-operative instructions.  To make it easy for you to refer to them, we've placed them on this website.  Please note, these are general instructions--if we've given you additional instructions in person, please refer to those as well. 

Below are instructions for the following: 

Post-Op Instructions For Nail procedures

Post-Op Instructions For Wart excisions

Pre-Op Surgical Instructions For Larger Procedures

Post-Op Surgical Instructions For Larger Procedures


Post-Op Instructions For Nail Procedures    

  • Nail procedures can bleed immediately after they're done.  So go home immediately after the procedure, and stay off your foot for the rest of the day.   

  • We typically apply a tight bandage immediately following nail procedures in order to diminish the likelihood of bleeding following the procedure.  Take this off 1.5 - 2 hours following the procedure, and keep it covered with a simple band-aid. 

  • If the toe does bleed, you can reapply the tight elastic dressing for another hour, elevate it (6 to 8 inches above your heart) and apply ice across the top of the ankle. 

  • Soak the toe in salt water (Epsom salts or table salt is fine) twice per day.  Use a couple of tablespoons of salt to a liter of water.  Soaking the toe in salt water helps dry out the toe and speeds healing. 

  • Whenever you are not soaking the foot or bathing, it is important to keep the toe covered with a Band-Aid throughout the healing process.  Do not let it air dry.  Use a non-stick bandage that completely covers the wound.  Change the bandage regularly, preferably several times per day.  When you take off the dressing, you'll see a lot of drainage, and this is good.  All the drainage must be completely gone in order for the toe to heal.  The more often you change the dressing, the quicker the toe will heal.

  • The anesthetic will typically wear off in 4 to 8 hours after the surgery, but the foot may remain numb for 10, 12 hour or more.  We had one patient in 2006 who remained numb for 60 hours.  So if you wake up tomorrow and the toe is still numb, don't worry. 

  • If we've done a procedure with radiosurgery, it will take a week or two to heal.  Chemical procedures usually take three or four. 

  • Return to the office in about a week for a check on your healing. 

Contact The Office If...

  • You notice excessive bleeding

  • You develop a fever

  • You have any questions


Post Op Instructions For Wart Procedures             

  • Wart excisions tend to bleed, so go home immediately after the procedure, and stay off your foot as much as possible.   

  • Keep the foot elevated 6-8 inches above your heart. 

  • The anesthetic will typically wear off in 4 to 8 hours after the surgery, but the foot may remain numb for 10, 12 hours or more.  One patient in 2006 remained numb for 60 hours, so if you wake up tomorrow and can't feel pain, don't worry. 

  • (Assuming you can take these drugs), take two over-the-counter Ibuprofen (Motrin, Advil) at each meal.  Half way between meals, take Tylenol.  These should help with any pain. 

  • A small amount of bleeding and drainage (roughly 1-2 inches in diameter) oozing into your dressing is normal post-operatively.  It should not be actively expanding, though, and it should be pretty much dry by the next day.  If significant bleeding occurs, please call us. 

  • Do not remove the dressing we've applied.  We will change the dressing at your first post-operative visit 1-3 days after the procedure. 

  • Keep the foot dry at least until the first post-operative visit.  At that time we will instruct you when you may get the foot wet. 

  • If the foot gets wet accidentally, let us know. 

  • Healing time varies, depending upon the size of the wart.

Contact The Office If...

  • You notice excessive bleeding

  • You develop a fever

  • You have any questions

 


Pre-Op Surgical Instructions  

  • No more than one week before the surgery, we will usually ask you to have pre-operative blood work performed.  Make certain you do this before the surgery. 

  • Surgical fees are partly covered by MSP for the surgery, but in most cases there will be additional costs.  These costs are usually reimbursed by your extended benefit program or government agencies like WCB, ICBC, RCMP, Indian Affairs, MSSH, and DVA.  Costs for the materials will obviously vary, based on the materials used for each procedure. 

  • Please arrive at Dr. Schumacher's surgical suite on time or slightly before you are scheduled for surgery.   

  • So long as the procedure is done under local anesthesia, you may eat before the surgery.  Do not drink excessive amounts of liquid pre-operatively, as you will not be able to use the rest room during the procedure.  

  • Wash your foot thoroughly with soap and water the night before the surgery.

  • Remove all nail polish prior to the day of surgery.

  • Do not shave any hair at the surgical site.

  • Do not use aspirin, ibuprofen or other non-steroidal anti-inflammatory medications for a week before the surgery unless pre-approved by Dr. Schumacher.

  • If you take any medications, please continue to take them as usual the day of surgery unless Dr. Schumacher instructs otherwise. 

  • Please make arrangements to be driven to and from the surgical suite on the day of the surgery. 

  • In addition, after some types of foot surgery, you may not be able to drive for several weeks post-op. 

  • If instructed to do so by our office, please bring crutches at the time of the surgery.   If you don't have any, we can provide you with some--but contact the office ahead of time to make sure we have some in stock.

  • Before the procedure, discuss with Dr. Schumacher any travel plans you may be considering after the procedure. 

  • Any family or friends waiting for you while you have the surgery performed can wait in our waiting room.  We have a TV there, up-to-date magazines.  There's a Starbucks and Guildford Town Centre Mall a short distance away. 


Post-Op Surgical Instructions  

  • Do not remove the Bandage.   The dressing we applied was put on in a sterile fashion. If you remove the dressing, you only tend to contaminate the wound, and increase your odds of infection.  If you have a lot of pain post-operatively, however, swelling may have occurred and the dressing may now be too tight.  In this case, you may loosen the outer portion (the brown elastic portion) of the dressing.  If you have a cast on instead of a dressing, call the office.
  • Keep the foot completely dry.  Water is not sterile.  If the foot gets wet, the odds are much greater that you will develop an infection.
  • Stay off your feet as much as possible.  The most common complication with any foot surgery is swelling.  If you are on your feet, your odds of having post-operative swelling go up, and this only slows healing.
  • Keep your foot elevated whenever possible.  It is best to keep your foot elevated 6-8 inches above your heart after surgery.  This will decrease your odds of getting post-operative swelling.  Put a pillow under your knee, so it stays bent slightly.  This will keep your knee from being strained.  Don't put your foot higher than 8 inches above your heart, though, as this can make it harder for the blood to pump into your foot (which you need to heal).
  • Apply ice for the first 48 hours.  Apply ice for 15 minutes per hour.  Protect your foot from getting wet by using a plastic barrier of some sort around the ice.   
  • Take all medication as directed.  We usually prescribe Ansaid or Toradol for pain, but we may prescribe other medications, depending upon the patient and procedure.  We usually ask you to take these with meals for pain.  You can take Tylenol between meals for additional pain relief. 
  • If you have any problems, call us.  You may either call Dr. Schumacher at the main office in Surrey (604.589.5234), or if it's after hours, call him at home (604.589.5238).  If Dr. Schumacher is unavailable, call one of the Vancouver Hospital residents.  Their phone numbers are on your post-operative instruction sheet. 
  • If this is an emergency and you cannot get in touch with us for any reason, go to the nearest hospital emergency room.

 

 

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www.FootDoc.ca

This website is operated by 
The Achilles Foot Health Centre
S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
Dr. S. A. Schumacher, Podiatric Corporation  

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