Hammertoe and Bunion Post op Dressing

Post-operative Hammertoe Dressing

Dressing Application Steps

  • Positioning the Toe

    • Plantarflex the proximal phalanx.

    • Hyperextend the distal part of the toe.

Initial Dressing Technique

  1. First 4x4 Wrap

    • Use a 4 by 4 gauze.

    • Wrap lengthwise around the toe to aid in plantarflexion of the proximal phalanx.

  2. Second 4x4 Wrap

    • Take another 4 by 4 and fold it in half lengthwise.

    • Apply this to the distal part of the toe to extend the distal aspect, ensuring a rectus position.

  3. Additional Padding

    • Apply 4 by fours dorsally and planarly over the incision for added protection and padding.

Cling Dressing Application

  1. Wrap the Cling Dressing

    • Use cling gauze to hold the 4 by fours in place, starting distally.

    • Ensure the toe is held in a rectus position by applying cling on both lateral and medial sides.

  2. Proximal Wrapping

    • Continue wrapping the cling dressing around the foot in a proximal direction.

    • Cover the heel and proceed to wrap around the ankle, making sure to dorsiflex the foot.

Final Layer of Dressing

  1. Apply Cast Padding

    • This is the last layer for added protection.

  2. ACE Bandage or Coban Wrap

    • Apply either the ACE bandage or coban wrap without excessive tension to avoid discomfort during normal postoperative swelling.

    • Ensure the ankle is dorsiflexed during application to prevent strains in the dressing.

Post-operative Bunionectomy Dressing

Dressing Objectives

  • Protection, compression, and stabilization of the surgical site.

  • Early post-operative dressings are crucial for maintaining correction.

Dressing Steps

  1. First 4x4 Gauze

    • Fold in half lengthwise and use it to adduct the hallux.

  2. Second 4x4 Gauze

    • Again fold in half lengthwise and plantarflex the hallux.

  3. Soaked Dressings

    • Gauze can be soaked in Saline and Betadine to enhance the splint effect.

  4. Incision Coverage

    • Cover the incisions dorsally, medially, and planarly with additional 4 by fours.

Cling Dressing for Compression

  1. Utilize Cling Dressing

    • Helps keep dressings in place and provides the first layer of compression.

    • Pass cling between the hallux and the second toe to adjust correction through adduction and plantarflexion of the hallux.

  2. Proximal Cling Wrapping

    • Wrap cling proximally, covering the heel and locking dressing around the ankle while maintaining dorsiflexion of the foot.

Final Dressing Layer

  1. Apply Cast Padding

    • Provide additional protection.

  2. Final Wrap

    • Use an ACE bandage or coban wrap without excessive tension to prevent post-operative pain.

    • Remember to dorsiflex the ankle during this final wrap to avoid complications.

You have now successfully completed a postoperative dressing for both hammertoe and bunionectomy procedures.