How Often Should I Ice My Foot After Bunion Surgery

If you hit your thumb with a hammer, what do you do besides possibly scream a four-letter word?.....you ice of course. This principle applies to surgery as well. This reduces the swelling that naturally occurs after a procedure which itself is a form of trauma, and in turn reduces pain.

The first rule of icing your body anywhere is “protect your skin.”  The second rule of icing is “PROTECT YOUR SKIN!”  If and ice or a gel pack is applied directly to the skin without some type of barrier, cold injury can occur, even frostbite if you apply ice for longer than your physician recommends. 

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I recommend icing the surgical foot with a gel ice pack.  Gel packs cool down after use and reduce the risk of skin injury that can be caused by overuse of regular ice, or prolonged use of an ice machine.   Dr. Steinke will provide you with a free pack at your pre-op appointment but it is recommended at have at least three packs at home so you can rotate them and give them time to refreeze between uses.

A word on ice machines.  Ice machines are a great invention.   They make icing efficient and easy, and if the basin has ice in it, it will provide cooled water around the application area, and has a great ability for coldness to penetrate even a thick dressing.  Now a word of caution on ice machines.   More is not always better!  Never ice longer than 30 minutes, no matter the delivery system

Ice machines just like bags of ice or gel packs can cause injury to your skin, even frostbite if used improperly.  Most machines have settings for coldness, and a medium setting is recommended if used.   Again, never use longer than 30 minutes, and if you have a machine please discuss with Dr. Steinke before attempting to use.    

In the first 24 hours I like 30-minute applications of ice to the ankle, then 30 minutes off, every hour that you are awake.  Do not worry about applying at night or when sleeping.    If you are resting comfortably seated in a chair with your foot propped up, you can remove your boot to ice.   If you get up for any reason, however, make sure to put your boot back on first. Some patients are nervous and don’t want to take the boot off, and that’s okay, you can simply loosen the portion of your boot by your ankle and apply ice while leaving the boot on.

For example:

Apply ICE 10 – 1030 AM

Remove ICE from 10:30 to 11 AM

Apply ICE from 11 – 11:30 AM and so on and so forth

That is a lot of time spent icing, I get it, but it really helps reduce and for some eliminate post-operative pain when at rest. You can continue this schedule until your first f/u appt.   If you find that your pain is controlled and only feel minimal swelling you can reduce your frequency to 4 times a day for 30 minutes each application 24 hours after your procedure.  

After your first post-operative appointment patients will continue icing 3-4 times daily for an additional week, but now can apply directly over operative site since dressing is thinner.   Once your sutures are removed at 2 weeks after surgery, you can ice operative site anywhere from once daily at end of day or continue 3-4 times daily, every patient’s swelling and comfort with icing is different. 


Simplified Post-operative Icing Guidelines

Day of Surgery until follow-up visit (3-4 days): Ice off and on every 30 minutes

Post-operative day 3 to 14: Ice 3 to 4 times daily on top of foot

Post-operative day 14 until 6 weeks: Ice 1 -2 times daily to foot

Post-operative week 6 and beyond: Ice after activity if swelling noted

 

Every patient needs after surgery are different, so ask questions if you find icing difficult, or if you are only experiencing mild swelling, or feel you have more swelling than expected.  Dr. Steinke will cater a plan individually for you based on your recovery, not a predestined protocol. 

Click here to schedule an appointment with Dr. Paul Steinke, the 3Dbuniondoc

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