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Icing protocol

Day of surgery

The ice machine and wrap will be put onto your surgical site in the recovery room by the nursing staff.  You will have a thick dressing of bandages between the ice pack and your body.  Ice continuously with the surgical body part in elevation (if instructed to) until you see the clinical nurse for a bandage change the next day.  You will also see a physical therapist at the Stone Clinic, where you will be instructed on a new icing schedule.

Please note: The post-surgical bandages are usually quite thick, inhibiting the amount of cold that can penetrate to the skin.  This is the reason we allow continuous icing.  The thick dressing will protect your skin from getting an ice burn!  Most patients describe the icing over the thick dressing as “cool at best”.  The icing should never be painful or make the skin turn white.

Day after surgery

After the post-surgical bandages are removed, you will be re-wrapped with a much thinner bandage.  Your surgical body part will also be “waking up” from the anesthesia.

The new recommended icing schedule is 15 minutes on the body part, with 1 hour, 45 minutes with no ice pack on the body part.  This cycle is continued throughout the waking hours.

The physiological effects of icing are reduction of inflammation/swelling and pain reduction.  Icing causes constriction in the vessels, which decreases the blood flow to the area.  It also slows down the conduction of the pain sensation in the nerves.  As the ice pack is removed, the body reflexively dilates the vessels, causing blood to rush back to the body part.  Therefore, the result of icing is vasopumping, which has been shown to be most effective in moving fluids and reducing inflammation.

It is not recommended to sleep with the ice, as the symptoms of an ice burn may go unnoticed.  However, if you prefer to sleep with the ice, or have persistent swelling that causes your therapist to recommend sleeping with ice, you MUST place a towel between your skin and the icepack.  The sensation will be similar to the day-of surgery icing scenario.

The inflammatory process is most active in the first 24 hours after a surgery, persisting for up to 2 weeks.  We recommend that you continue the aforementioned icing routine for the first 2 weeks after your surgery.  This is a very effective way to maximize your healing environment.

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