Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Why Pre-Surgical Preparation Matters

The outcome of foot surgery is determined not only by the skill of the surgical procedure but also by how well prepared the patient is before surgery and how carefully they follow instructions afterward. Patients who complete pre-operative preparation properly have lower complication rates, better healing, and higher satisfaction with their outcomes. This checklist covers the key areas of pre-operative preparation for elective foot and ankle surgery — from medical preparation and home setup to financial planning and mental readiness.

Medical Preparation

Your surgical team will require pre-operative clearance from your primary care physician or cardiologist if you have significant medical conditions (heart disease, poorly controlled diabetes, lung disease, blood thinning medications). Schedule this appointment early — 2–3 weeks before the planned surgery date — to allow time for any additional workup that might be needed. Optimize your diabetes control: HbA1c levels above 8% are associated with significantly elevated wound infection rates, and many surgeons request optimization of glycemic control before elective foot surgery. Discuss all medications with your surgeon, as some (blood thinners, NSAIDs, certain supplements including fish oil, vitamin E, and garlic) must be stopped before surgery to reduce bleeding risk. Do not stop medications without specific guidance — particularly do not stop prescribed blood thinners without discussing with both your prescribing physician and surgeon.

Quit smoking if at all possible before foot surgery. Smoking dramatically impairs wound healing through vasoconstrictive effects on small blood vessels and toxic effects on healing cells — smokers have significantly higher rates of wound complications, infection, and bone non-union after foot surgery. Even quitting 4–6 weeks before surgery provides meaningful benefit.

Setting Up Your Home for Recovery

Planning your home environment before surgery dramatically reduces post-operative stress and potential complications. Set up a primary recovery area — a recliner or sofa where you can comfortably elevate your foot above heart level for most of each day — with everything you need within arm’s reach: medications, water, phone charger, entertainment, and easy-to-eat foods. If you live in a two-story home and your bedroom is upstairs, consider temporarily relocating to a first-floor sleeping space to avoid stair negotiation in the early post-operative period. Clear pathways of trip hazards (loose rugs, cords, clutter) to make crutch navigation safer. Secure your pets to prevent jumping-related injuries to the surgical site.

Install grab bars in the bathroom if not already present — both beside the toilet and in the shower. A shower bench or shower seat, available at most home goods stores, allows seated showering during recovery. A handheld showerhead attachment allows washing while seated without getting the operative foot wet if the boot or cast requires waterproofing.

Logistics and Support Planning

Arrange for a responsible adult driver to take you home after surgery and stay with you for at least 24 hours — anesthesia temporarily impairs judgment and balance, and driving is not permitted for at least 24 hours after sedation. If the surgery is on your right foot, you will be unable to drive for the duration of non-weight-bearing or until cleared by your surgeon — arrange transportation for work, appointments, and daily needs for this period. If you have children, arrange childcare coverage for the first several days when you are most mobility-limited. Grocery shopping and meal preparation planning before surgery — stocking the refrigerator and pantry with easy-to-prepare foods — prevents post-operative stress about meals when mobility is reduced.

Financial and Insurance Preparation

Contact your insurance carrier before surgery to confirm coverage, obtain any required pre-authorization, and understand your anticipated out-of-pocket costs (deductible, copay, coinsurance). If the procedure involves implants (screws, plates, fusion implants), inquire specifically about implant coverage. Confirm that the surgical facility is in-network for your insurance plan. Review your company’s sick leave, FMLA (Family and Medical Leave Act), and short-term disability policies to understand your income protection during recovery if you will be out of work. FMLA paperwork can be completed in advance with your surgeon’s office so it is ready to submit immediately after surgery.

Day of Surgery Instructions

Follow your anesthesia team’s NPO (nothing by mouth) instructions precisely — typically no food or drink after midnight the night before surgery. Shower the evening before and morning of surgery with the antiseptic scrub provided by your surgeon’s office (usually chlorhexidine) to reduce surgical site bacterial contamination. Wear comfortable, loose-fitting clothing on the day of surgery — sweatpants or wide-leg pants that can accommodate the post-operative dressing and surgical boot, and a shirt that is easy to take on and off. Remove nail polish from all toenails. Bring a list of all medications and your insurance cards. Leave jewelry, contact lenses, and valuables at home. Arrive at the surgical facility at the requested time to allow adequate pre-operative preparation.

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Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Preparing for Foot Surgery at Balance Foot & Ankle

Proper preparation before foot surgery improves outcomes and speeds recovery. At Balance Foot & Ankle, Dr. Tom Biernacki provides comprehensive pre-operative guidance tailored to your specific procedure — serving Howell and Bloomfield Hills, MI.

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Clinical References

1. McDonald S, Page MJ, Beringer K, Wasiak J, Sprowson A. Preoperative education for hip or knee replacement. Cochrane Database Syst Rev. 2014;(5):CD003526.
2. Parvizi J, Mui A, Purtill JJ, Sharkey PF, Hozack WJ, Rothman RH. Total joint arthroplasty: when do fatal or near-fatal complications occur? J Bone Joint Surg Am. 2007;89(1):27-32.
3. Bibbo C, Lin SS, Beam HA, Behrens FF. Complications of ankle fracture in diabetic patients. Orthop Clin North Am. 2001;32(1):113-133.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

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Dr. Carl Jay, DPM

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Dr. Daria Gutkin, DPM

Podiatrist

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.