1. Post-Surgery

What is P.R.I.C.E? Part I

“P.R.I.C.E.” is the mantra of recovery. These initials stand for Protection, Rest, Ice, Compression, and Elevation. The leg is well protected after surgery and needs to remain so. Even if you don’t feel intense pain, remember what you have just put your body through and treat yourself with care. Rest, especially sleep is essential during this period because the release of human growth hormone (HGH) primarily occurs during the first period of deep sleep. HGH restores bone and muscle tissue and helps cells regenerate and will be discussed more inThe Importance of Sleep.

You will likely find yourself wearing a compression sleeve to prevent the formation of blood clots in the deep veins of your leg. Referred to as IPCs or Intermittent Pneumatic Compression devices, these sleeves wrap around your calf like a large cuff and inflate, with pulsating air to squeeze your leg to increase blood flow. It is essential to increase blood flow to the leg because you will have at least two of the three factors are associated with decreased blood flow.

Keeping leg straight and elevated is important to both healing and recovery

These include:
1. Recent surgery
2. Limited mobility
3. Advancing years

Some medications minimize the risk of blood clots, but they may have undesirable side effects. Remember that if you need to apply ice to the back of your knee, you must remove the compression sleeve first.

It is necessary to distinguish between healing and recovery to understand why it is important to keep your leg elevated and iced immediately after surgery. Healing is a natural process—the regeneration of body cells that begins immediately after surgery. Recovery is the process by which the patient returns to a healthy state. Keeping the operated leg elevated and iced is vital to both. If the leg remains swollen, the swelling can act as a natural splint during the healing process, decreasing the mobility of the knee, limiting the range of motion, and resulting in a less than optimal recovery.

Elevating the foot above the hip level allows drainage for lymph and tissue fluids that are the primary cause of swelling and redness, heat, and pain. In severe swelling, the patient is urged to raise the toes above the nose.

Note: When elevating your leg, make sure to place the pillows under your lower calf and foot, never under just the knee itself, and keep your leg as straight as possible.

By reducing the temperature of the skin and muscles, and even the knee joint capsule itself, icing lessens the bleeding inside the knee joint post-surgery. It reduces fluid build-up, along with its attending symptoms. Icing also slows the activity of peripheral nerves, which can decrease the perception of pain.

While recommendations on how long to ice vary, there is complete agreement that one should never apply ice to bare skin. To avoid possible frostbite and a reduction in blood circulation, always wrap the ice or ice gel in a thin towel or a t-shirt before compressing it against the skin around the wound. Ask your surgeon what icing recommendation you should follow. A typical recommendation would be to ice for 20 minutes three to four times a day for the 48–72 hours post-surgery.

Next: P.R.I.C.E. Part II