Safe aftercare following foot ankle surgery: Doing less is more: The Jones dressing cast, part 2

Abstract

Background: There is no universal approach to surgery aftercare among foot and ankle surgeons. Although infections following foot and ankle surgery are rare, soft tissue healing can be jeopardized after extensive and multiple approaches.

Methods: We defined a precise fixation technique of the foot and ankle in the immediate post-operative phase using what we call "the Jones dressing cast". This technique is a modification of the Jones dressing bandage. In a previous study we compared two groups of patients (N=20/23) who underwent similar reconstructive surgery with the application of the described cast for one week and without. At the two-month follow-up we observed that the group treated with the cast required less pain relief, spent less time in hospital and achieved faster autonomy using crutches (Gottlieb and Klaue, 2013). In this study we considered a group of 45 patients who underwent similar reconstructive procedures to those in the first study and who were treated with the cast for two weeks post-operatively. There was no visual check of the soft tissues before removal of the cast.

Results: Unlike the earlier study, the results from this second study were more significant. Revision surgery occurred far less frequently in the group wearing the cast for two weeks.

Conclusions: The reduced strain to the soft tissue around the foot due to the cast and less manipulation of the wound dressing decrease complications in the post-operative period.

Keywords: Cast; Complications; Foot surgery; Jones dressing; Post-operative wound management.