What do you think about intra-operative steroid injections following bunion surgery?

Not necessary : Post operative steroid injection at the surgical site after bunion surgery in my opinion is not necessary or helpful it may even slow down local wound healing even though I am not aware of any data to support it i just do not see much benefit from it systemic steroids however are different story i hope that helps.

Excellent question: Injecting a small amount of a steroid is not uncommon after skin closure. There are different schools of thought. One is that any steroid can inhibit wound healing. The other is that a small amount can significantly decrease post op inflammation, which in turn decrease pain that is caused from inflammation. The steroids used intra op are usually phosphates, which are short acting steroids.

Generally not needed: I will sometimes inject steroid medication into the site of surgery if I feel that this is necessary based on intraoperative findings of significant inflammation within the joint or concern for flare. But, more often than not I do not. I do not feel that it inhibits healing times.

Believe it on not.: When properly used, steroid use can lower post-operative pain and swelling issues to down right scary levels. After almost forty years of using them, I have seen no evidence of delayed healing or impaired immunity.

Post op steroids: For years I was afraid that my incision was going to dehisce and the orient was not going to help due to the steroid. I began using dexametasone for post op injection, I have not seen complications and same results as when I did not used it. So I'll use it if they offered.

Avoid it: Though it helps diminish synovitis in the operative setting, steroids low soft tissue and bone healing and increase risk of infection.

Please clarify: Dr. Rafat, Apologies in missing something in the wording since I'm not a surgical specialist but I'm confused by the term "INTRA-operative" steroid injection FOLLOWING bunion surgery. It sounds as if the injections are already given at the time of surgery so what is it that is being done FOLLOWING surgery in order to complete the question? Perhaps you are asking about a 2nd round of shots?

May be: helpful. Because in dupytrins contractures of hand this is quite effective. but please remember bunions is not a disease these are reactive to undue pressure especially due to tight shoes.

Mixed opinions: Short acting cortisone given post op into the surgical site has a very long history of use and success although recent studies may argue against their use. With this said: I routinely gave dexamethasone injections post op ( unless there was a contraindication) for 35 years and can say that is dfinately helped decrease post op inflammation and pain and decreased overall healing time.

May want to avoid: The concern of course would be that steroids can delay healing and suppress the immune system as well as increase blood sugar levels. All of this could potentially increase surgical healing problems and infection with probably very limited benefit. I personally would avoid there use.

Not good idea: After such surgery, on the foot with high risk of infection, it will be asking for it to do such an injection, plus it will lead to almost zero benefit. It will highly risk post-operative infection. Don't do it.

Bad idea: It can lead to wound complications such as slow healing of the surgical wound. An inflammatory response is part of the normal healing process. It can be used occasionally if patient is prone to keloid scarring.

GOOD IDEA: I, like most podiatrists, use a phosphate injectable steroid after the wound is closed; before the dressing is applied. Usually it's combined with a long acting anesthetic.