“Us vs. Them”

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“Us vs. Them”

There are two basic types of foot surgery.

Them
Higher Risk Surgery

 Anesthesia: General anesthesia most likely used with narcotics.

Extent of Trauma: Prominent scarring at the incision site with extensive local tissue damage. Internal fixation is frequently required and may necessitate future removal of hardware or casts.

 Incision Size:  Larger wound openings require larger closures and cause larger scars.

 Instrumentation:   Wires, pins, screws and implants used in conjunction with hammers, chisels, rongeur, and saws are generally utilized for bone operations. 

 Locale:    In-patient hospitalization and surgery room are usually required.

Postoperative Care:  Immobilization, crutches, casts and/or rigid footgear often utilized. Narcotics often prescribed.

Preoperative Laboratory Tests:  Routine lab tests are ordered, as well as additional x-rays which may be hospital policy.

Preoperative Preparation: Operating room sterile attire and technique are mandatory since the large operative area is exposed to the surrounding environment.

Preoperative Sedation: Sedation is required.

Scheduling: May need to plan and schedule well in advance for health, lifestyle and other reasons.

 Sutures: Large incisions that require multiple sutures to close the tissue.

Infections: Higher Risk of infection due to larger openings and more invasive procedures used to correct the foot.

Us
Minimally Invasive Surgery

 Anesthesia:  Nitrous Oxide with local anesthesia is used.

Extent of Trauma:  Internal fixation not required. Trauma to dermal, subcutaneous tissues and scarring is minimal.

 Incision Size: Usually 1/4-inch incision.

 Instrumentation: Small surgical rasps are predominately used to for bone operations.

 Locale: Performed in a state of the art, comfortable, surgical suite.

Postoperative Care: Mild, over the counter, or prescription analgesics.

Preoperative Laboratory Tests: Foot x-rays are mandatory in bone surgery and performed on-site.

Preoperative Preparation: Sterile technique and attire.

Preoperative Sedation: Not necessary.

Scheduling:  Surgery can be performed any time the doctor and patient mutually agree upon.

 Sutures: One small, suture is usually only needed.

Infections: Low Risk

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Definition of Standards of Care Approved by the Academy of Ambulatory Foot and Ankle Surgery

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