Patient Name __________________________________________________________________________
Your foot surgery is scheduled at ____________________________________ on __________________
(facility) (day and time)
You can help greatly to promote healing by doing the following:
- Scrub your feet with Hibiclens (you may obtain this from the pharmacy) two times the day before your surgery for 10 minutes each time.
- Place both feet in a basin with lukewarm water.
- Remove one foot from the basin and apply a few drops of Hibiclens to the skin and the brush, then scrub the entire foot and above the ankle.
- Return the foot to the basin and repeat with the other foot.
- Arrange for transportation home and for someone to assist you at home for at least 24 hours after your surgery: YOU WILL NOT BE ALLOWED TO DRIVE YOURSELF HOME!!!
- If you take any medications regularly, please bring them with you. Take your medications as directed by your doctor.
- 4. DO NOT EAT OR DRINK ANYTHING 12 HOURS BEFORE SURGERY.
- On the day of surgery, bring 2 pillows to elevate your feet while sitting in the back seat of the car on the way home.
- Have an ice pack available for use when you arrive home after surgery.
- Arrive at the hospital or surgery center at least two hours prior to your surgery time or at the time they request.
- Take your surgical shoe or boot with you to the hospital if dispensed in the office at your pre-operative visit.
- Fill your medication prescription the day before the surgery (if it has been given to you) to have available if necessary.
- Please remove all nail polish, make-up, jewelry, and contact lenses before coming to the hospital.
- A container will be provided to store any removable dental apparatus or eye wear while you are in surgery.
- If you should develop fever, cold or flu symptoms, or any change in your general health prior to surgery, please call AS SOON AS POSSIBLE. It may be necessary to change your surgery date.
- It may be necessary for you to spend the night in the hospital if you develop any condition that warrants this.
- There is a surgical waiting room available for family and friends. Expect at least one hour of recovery time plus surgery time.
- If you have any questions prior to surgery, please feel free to call our office at 543-2476.
- Wear loose, comfortable clothing. Bring a robe and slippers to the hospital or surgery center.
- Special Instructions:____________________________________________________________________
Patient Signature ___________________________________________ Date ______________
Nurse Signature _______________________________________________________________