Preoperative Management

  • Patient Assessment and Evaluation

    Medical History: Obtain a thorough medical history, including any pre-existing medical conditions, allergies, previous surgeries, and current medications.

    Physical Examination: Perform a detailed examination of the foot and ankle, assessing vascular status, neurologic function, and musculoskeletal alignment.

  • Laboratory and Diagnostic Tests

    Blood Work: This may include a complete blood count (CBC), basic metabolic panel (BMP), coagulation studies, and blood typing if necessary.

    Imaging Studies: X-rays, MRI, or CT scans may be ordered to assess the anatomical structures, pathology, and alignment of the foot.

  • Cardiovascular Assessment

    ECG (Electrocardiogram): Consider performing an ECG, especially for patients with cardiac risk factors, to evaluate cardiac function.

  • Anesthesia Evaluation

    Consultation: If general anesthesia is planned, the patient may need to undergo a preoperative anesthesia evaluation to assess their fitness for surgery.

  • Medication Management

    Review of Current Medications: Evaluate the patient's current medication regimen and make any necessary adjustments, particularly regarding medications that may affect bleeding or anesthesia.

  • Preoperative Fasting

    NPO Guidelines: Advise the patient on fasting guidelines, typically requiring no food or clear liquids for a specified period before surgery.

  • Informed Consent

    Discussion and Documentation: Discuss the proposed procedure, potential risks and benefits, and obtain the patient's informed consent. Document this conversation appropriately.

  • Preoperative Skin Preparation

    Preoperative Shower: Instruct the patient to shower with an antimicrobial soap the night before or the morning of the surgery.

  • Preoperative Medications:

    Prophylactic Antibiotics: Administer prophylactic antibiotics as per institutional protocols to reduce the risk of surgical site infections.

  • Patient Education

    Postoperative Instructions: Provide the patient with clear postoperative care instructions, including weight-bearing status, wound care, and any prescribed medications.

  • Arrangements for Transportation and Aftercare:

    Transportation: Ensure the patient has a plan for transportation to and from the surgical facility.

    Aftercare: Discuss arrangements for postoperative care, including any necessary accommodations or home healthcare.