General Postoperative Instructions
These instructions are intended as example general instructions after orthopaedic surgical procedures performed by Dr. Riehl. You should have individualized postoperative instructions from your surgery. If your surgeon has given you any instructions that are contrary to those contained here, follow the instructions you were given. This information is not intended in any way to take the place of information provided to you by a medical professional.
1. Ice and elevate
As much as possible throughout the days following surgery (and especially at night), elevate the affected extremity. Elevation is generally most effective when the foot (or in the case of an arm injury, hand) is higher than the knee (elbow), and the knee (elbow) is higher than the heart. Swelling can be a major source of pain after an injury or surgery and is very much affected by gravity. Therefore, more elevation = less swelling.
Ice is also very important in pain control. Using a large zip top bag full of ice placed on top of and around the surgery site is often more beneficial in pain control than are oral pain medications. Be careful not to allow dressings/splints to become wet. Care must be taken with icing to avoid frostbite injury to the skin.
2. Keep the surgical dressings clean and dry
Your surgical dressing was placed in a clean sterile environment. Unless otherwise directed, you may leave it in place until your follow-up appointment as long as it stays clean and dry. Visible blood on the bandage or splint can be perfectly normal after surgery, as the bandage/splint tends to act like a sponge and spread even small amounts of blood over a large area. If the dressing is not saturated, it is probably OK. If it is saturated, your surgeon should be notified and the bandage can be changed with gauze and tape, or reinforced. Splints should be left in place even when drainage appears. The dressing can be reinforced and your doctor notified. Sutures/staples remain in place until your follow-up visit with your doctor.
3. Follow post-operative weight-bearing instructions
You may or may not be allowed to put weight (i.e. walk, use your arms to push up from a chair, etc.) after surgery. You will be given weight-bearing instructions in the recovery room after surgery. If you are unsure about weight-bearing or uncomfortable weight-bearing you may remain non-weight-bearing until your first follow-up appointment.
4. Pain is a normal part of injury and surgery
Although everyone tends to experience pain differently, you are likely to have pain in the post-operative period. If you were a candidate for and received an injection that made your operative site numb after surgery, you may not have pain on the day of surgery. This numbing medicine will wear off and the normal pain that people then experience is very surprising to some. This problem can be helped by taking pain medicines on the day of surgery before the numbing medicine wears off and before bedtime that night even if you are not yet experiencing pain. Your anesthesiologist can discuss this in depth with you on the day of surgery.
As stated above, some of the best things you can do to decrease your pain are ice and elevation. Pain medicines can be taken as prescribed, but do not take them any more frequently than prescribed. If pain continues without improvement despite ice, elevation, rest, and medicine, or if you just feel the pain is more severe than it should be, call your doctor’s office for further instruction. Excessive pain can be a sign of a rare but serious problem known as compartment syndrome.
5. Fever
A low-grade fever (100.5) is not at all uncommon in the first 48 hrs after surgery. Beyond that a persistent fever should prompt you to contact your doctor’s office.
6. Therapy
If you received a prescription for physical therapy when you were discharged you should attend as directed. If you did not receive any therapy orders or have not previously made therapy arrangements prior to your surgery, you will not need therapy between surgery and your first post-operative visit.
7. Follow-up
You will need to follow-up with your doctor within 2-3 weeks after surgery. If an appointment has not been made for you by the time you leave the hospital, call the office on the next business day to schedule an appointment.
8. Driving
You cannot drive a car until:
1) You are no longer taking narcotic pain medications
2) You are no longer wearing a cast or brace that would inhibit your ability to drive safely
3) You can put enough pressure on your foot to slam on the brake in an emergency
4) You are able to perform all functions of driving to the degree you were able to perform them before your injury/surgery.
…when in doubt, don’t drive.
9. Return to work/school
Returning to work depends largely on the demands of your job and the accommodations that can be made for you at work. In general, if you can go to school or work and follow all postoperative instructions at the same time, that is OK to do. Of course, narcotic medication cannot be used in any way if operating any type of heavy or dangerous machinery.
10. If chest pain, shortness of breath, excessive nausea or vomiting, or any other conditions develop that would constitute an emergency, go immediately to an emergency Department or dial 911.