The complexities of self-harm in foot & ankle surgery

Abstract

This paper delves into the complexities of self-harm within the context of foot and ankle surgery, an aspect often overlooked in the surgical realm. Mental health's impact on surgical outcomes, particularly in podiatric surgery, is explored, emphasizing the need for routine pre-operative mental health assessments. The prevalence of mental health disorders in patients with musculoskeletal conditions, their influence on pain perception, and the interplay with immune system dysregulation are discussed. Recognizing the intricacies of self-harm, the paper provides guidelines for practitioners to navigate these conditions, including the importance of compassionate responses, motivational interviewing techniques, and specialized psychiatric referrals. Screening tools for anxiety are outlined, and considerations for wound management in cases of self-inflicted injuries are detailed. The paper highlights the effects of self-harm on surgical outcomes, including complications, prolonged recovery, and challenges in post-operative care adherence. Treatment recommendations encompass preoperative screening, patient education, anxiety-reduction techniques, medication management, and a multidisciplinary approach involving mental health professionals. The conclusion advocates for a collaborative care model between podiatric surgeons and mental health professionals, emphasizing the significance of preoperative psychological evaluations in optimizing surgical outcomes and providing holistic podiatric care. The paper also identifies areas for future research, including the direct impacts of self-harm on postoperative outcomes and wound healing, and the need for further assessment in podiatric procedures.

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