Time Line for Bunion Surgery
Day of Surgery - Day 1
The surgery is performed on this day, and requires approximately 90 minutes of surgical time for both feet. In addition, preparation time before the surgery and recovery time after the surgery is also needed. The total amount of time spent at the surgical facility or hospital is about four hours. Prior arrangements for transportation home after the surgery must be made.
The most common type of anesthesia that is used is called "local anesthesia with intravenous sedation." Other similar names are "twilight anesthesia," MAC or conscious sedation. This type of anesthesia is extremely safe. The patient has an IV in the arm, and breathes with the assistance of an oxygen mask. There is no memory of pain or hearing undesirable sounds. An anesthesiologist is present at all times throughout the surgery and administers various medications through the IV, depending upon the requirements or desires of the patient. Due to the types of medications that are used, there is rarely nausea or stomach upset after the procedure. The surgical experience is pleasant, with the patient waking up with little or no memory of the surgery!
The patient leaves the facility walking with special surgical shoe only. It will be provided for the patient. Crutches or walkers are NOT needed. There is no cast on the foot, only a soft gauze dressing. The dressing must stay dry and is not changed until the first post-op office visit.
The application of ice packs to the foot is important. Apply a towel around the ice pack to absorb any condensation from the ice. New ice packs should be applied about four times each day, for the first 3 or 4 days. Ice is not needed during the night. The ice can be positioned on the foot using a large rubber band. Some patients like using a bag of frozen peas or carrots instead of an ice pack. Ice cubes in a Zip Lock plastic bag can also be used.
The patient may ambulate for short distances within the home or to a car during this period, using the surgical shoes.
It is equally important during this time to keep the foot elevated to the level of the waist, supported by another chair or small table.
Those patients that elevate their foot and apply the ice packs report minimal post-operative pain, experience the least amount of swelling and require the least amount of pain medication. Ice and elevation is VERY important. The reduction of foot swelling during this period will have a significant effect on the entire recovery process.
First Post-Operative Visit - Day 3 or 4
The patient comes to the office. The sutures (stitches) are NOT removed at this visit. Only the bandages are changed. Postoperative x-rays are taken.
It is normal to see mild bruising and some dry blood on the foot.
The patient continues to wear the same surgical shoe, with limited and gradually increasing ambulation.
It is extremely important to avoid excessive ambulation during the first two weeks, as it will cause increased foot swelling and a delay in healing.
Second Post-Operative Visit - Day 14
The patient comes to the office, where the dressings and the sutures are removed. Removal of the sutures is only minimally uncomfortable. The patient leaves the office without dressings, but with a special cotton sock and the surgical shoe.
The following day, the patient may take a complete shower or bath, getting the foot wet as usual. Do NOT use a jacuzzi or hot tub which may cause increased swelling.
Weeks Three and Four
During this period, the patient will start wearing a wider shoe or half-size larger athletic shoe. The comfort levels will vary. Do not push yourself. The larger shoe is needed due to moderate foot swelling which is normal at this time.
Be sure to do the big toe exercises twice a day, as described in the office. Depending upon need, physical therapy may be recommended at this time .
At this time skin emollients such as aloe vera or Vitamin E may be applied around the healing wound. Once the wound is totally closed, these lotions may be applied over the wound.
Third Post-Operative Visit - Week Five
You will be seen in the office to evaluate your healing and ambulation. Mild exercises may begin, including short distance walking. Avoid strenuous exercises such as tennis.
You should notice a significant decrease in foot swelling (edema).
Six to Eight Weeks Post-Operative
Most common exercises are performed to about 80% of their usual level.
NOTE: INDIVIDUAL PATIENTS WILL VARY IN THEIR EXPERIENCES.