Podiatric Surgery provides an alternative to Orthopaedic Surgery and is performed using local anaesthetic and is undertaken on a daycase basis (with the patient going home on the day of the operation).
- Patients with foot pathologies that need a surgical opinion
- Patients that are able to have surgery under local anaesthetic
- Patients under 16
- Patients who have not had any basic podiatry or conservative care for their problem – see above.
- Primary nail and nail fold conditions (decommissioned)
- Diabetic foot ulcers (diabetic foot pathway)
- Skin coverage problems (plastic surgery)
- Vascular disease (general/vascular surgery)
- Medical skin diseases (dermatology)
- Diagnosis and medical management of inflammatory arthritis (rheumatology)
- Pain management (pain clinic)
- Trauma (orthopaedics)
- Malignant tumours (MDT).
The following patients may be excluded from day case surgery listing:
- Patients whose foot pain results from inappropriate footwear
- Patients who have not yet tried conservative management without success
- Patients without a responsible adult available to be with them for the first 24-48 hours after discharge
- Patients without General Practitioner (GP) out-of-hours back-up available locally.
- Patients above ASA grade 3
- Patients without access to telephone at home, or unable to arrange appropriate time to recuperate after surgery
- Patients with a BMI greater than 35 (due to the difficulty of ensuring effective load protection to the foot as a day case
- Patients with significant haemophilia, sickle cell disease or thalassaemia
- Patients on renal dialysis
- Patients with a history of malignant hyperpyrexia
- Patients with MRSA (will be deferred until clear)
- Patients with poorly controlled asthma (frequent hospital admissions within the last 3 months
- Patients with poorly controlled hypertension (diastolic over 105) or unstable angina
- Patients with a history of Ml in the last six-months
Referrals can be made using a standard referral letter.