Post-operative Instructions

General post-operative instructions

  1. Elevation: Keeping your hand above the level of your heart reduces swelling and pain. The first couple of days after surgery is when this is most important. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand. At night, place your arm on pillows to elevate. Move your shoulder frequently to help reduce stiffness. Continue elevating your arm until your follow up appointment.
  2. Dressing/Splints: Do not remove the surgical dressing after your surgery. The dressing is necessary to protect the surgical incision, prevent wound infections and keep your hand/wrist in the proper position after surgery.
    1. You may shower with the dressing in place by covering it with a plastic bag (secured with tape) or with Press-n-Seal or plastic wrap. Keep the dressing dry.
    2. There may be bloody drainage on the dressing – it can be normal for the incision to ooze for a day or two after surgery.
  3. Pain Management: You will be given a prescription for pain medication either prior to or on the day of surgery. Use as directed if needed.
    1. You may also take one of the following over the counter medications in addition to the prescription: Advil/Motrin/Ibuprofen 400-800mg every 8 hours or Aleve 220-440mg every 12 hours if needed.
    2. Avoid Tylenol if you are taking the pain prescription as it usually has Tylenol combined with a narcotic. You may take Tylenol if you are not taking the pain prescription.
    3. A common side effect of narcotic medications is constipation: start taking a stool softener starting the day of surgery. Colace or Senna are over the counter stool softener found at pharmacies.
  4. Nausea: Pain medication or anesthesia-based nausea can occur after surgery. If it does, please notify Dr. Stuart’s office and a medication can be prescribed for it.
  5. Follow up appointment: An appointment for follow up has been made for you on.

If you have a splint that was given or made for you in Dr. Stuart’s office, please bring it to your post op appointment.

If you have any questions or concerns prior to then, please don’t hesitate to call 804.320.1339 and ask to speak with Dr. Stuart’s team.

Specific Post-operative Instructions

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. Stitches will be removed one week after surgery in the office. It is okay to wash the dried blood around your incision with peroxide on sterile gauze one time.
  3. Elevate your hand above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand.
  4. Report redness, swelling or drainage to our office at 804.320.1339.

Activity

  1. Move the other joints of the finger frequently, straightening them completely, and making a full fist several times per hours.
  2. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)
  3. Wear your splint at all times – removing for hygiene and for exercises for the other joints of the finger.

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. Pain at the surgical site can occur with direct pressure over the incision, such as that experienced when pushing yourself out of a chair.
  3. Numbness and tingling may linger for a short while, but improves with time after surgery.
  4. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.

Please make an appointment to be seen if you having concerns.

Equipment

  • 2 plastic dish pans or double sink.
  • Timer
  • Sponge

Instructions

  1. Fill one pan with hot water (as hot as tolerable without burning yourself) and one pan with cool water (as cold as tolerable). Fill high enough so the wrist and hand are covered.
  2. Place your hand in the hot water first.
  3. Squeeze a sponge, or open and close your fingers for 5 minutes.
  4. Then place your hand in the cold water.
  5. Squeeze a sponge, or open and close your fingers for 5 minutes.
  6. Alternate between the hot and cold water every 5 minutes , for a total of 15 minutes.
  7. End with the cool water!

This treatment will decrease your pain, swelling or stiffness. It may also help increase range of motion.

Please make an appointment to be seen if you having concerns.

As part of your treatment you have received an injection of cortisone. Cortisone is a naturally occurring anti-inflammatory hormone which exists in the body at all times.

Injections are used to reduce inflammation in tendons, ligaments, and joints. For arthritic conditions it can be helpful for short-term pain relief (weeks to months). For inflammatory conditions, injections can result in long term or permanent relief from a single shot.

The type of cortisone used for musculoskeletal injections works locally, and is less likely to have some of the generalized side effects of oral cortisone.

The common side effect of local cortisone injections is temporarily increased pain in the area following the injection.

There are very rare side effects of occasional flushing in the face for several hours to a day following the injections, possible de-pigmentation of the skin in the area of the injection, thinning of the skin, or infection.

After the Injection

  1. The area may initially be numb as a result of the Lidocaine, which is a local anesthetic used in conjunction with the cortisone to provide temporary relief in the injected area. Numbness will normally only last for 1 hour.
  2. Most patients tolerate cortisone injections well, however there is a common side effect called a “cortisone flare.” This reaction may cause the patient a brief period of pain worse than before the injection. It typically only lasts for 1-2 days and is best treated with rest and application of ice packs to the injected area. Do not apply ice directly to the skin – it should be enclosed in a plastic bag and wrapped in a cloth/towel. Ice should be applied for 10-20 periods of time in an on/off cycle.
  3. Persons with diabetes may notice an increase in their blood sugar and should closely monitor for 2-3 days after the injection.

Cortisone injections generally begin working within 2-5 days, and may require 7-10 days for full effect. You should limit significant use of the affected joint (i.e. avoid sports, heavy lifting, etc.) for about 7 days, or per your physician’s directions.

Please call our office if you have any questions about any post-injection symptoms that concern you.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site.
  3. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. The long arm dressing/splint will be removed at your first post-operative visit and replaced with an ace bandage. The ace wrap is used to protect the incision from direct pressure. You may remove it for hygiene but continue to wear it for 1 week. After 1 week, you may leave the incision open to air.
  2. Move your fingers frequently, straightening them completely, and making a full fist several times per hour. Move your elbow after you move your fingers with gentle bending and straightening.
  3. Refrain from pushing, pulling, lifting or grabbing with the operative arm and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. You may gentle move your elbow. DO NOT lift any weights in the hand as your move the elbow.
  3. Nighttime awakening (related to your cubital tunnel syndrome) usually goes away soon after surgery.
  4. Numbness and tingling may linger for a short while, but improves with time after surgery. For severe cases, recovery of sensation may take up to two years and sometimes may be incomplete.
  5. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.
  6. It can take anywhere from 4-6 months to regain strength in the arm after cubital tunnel surgery. Please make an appointment to be seen if you having concerns.

A Patient Guide

Dupuytren’s contracture affects the palmar fascia, a reinforcing mesh which lies just beneath the skin of the palm. Needle Aponeurotomy is a minimally invasion treatment for Dupuytren’s Contracture. This handout explains the procedure.

Before the procedure

  1. Food: Unlike traditional surgery, it is safe to eat before the procedure.
  2. Medication:
    1. If you are concerned about being anxious, or have had to take anti-anxiety medicine in the past for dental procedures, its reasonable to take anti-anxiety medication such as Valium or Xanax before this procedure. Please notify us if you think you may need an anti-anxiety medication.
    2. If your regular doctor has recommended that you take prophylactic antibiotics before surgery because of a joint replacement, heart disease or other medical problems, it is appropriate to take that type of medicine before this procedure. You will need to notify your regular physician to obtain a prescription.
    3. If you take aspirin, vitamin E or blood thinners such as Coumadin, or have any questions about your medications, please check with our staff prior to your appointment.
  3. Skin Problems: If you have recent injuries, wounds, insect bites or healing areas involving the palm of the hand or the fingers, it might not be safe to proceed with needle aponeurotomy because of the risk of infection. Please notify our staff if you have any wounds or infections.

Common questions about the procedure

  1. What is actually done during the procedure? The procedure is performed while you lie down on your back with your arm stretched out. Dr. Stuart will use a marking pen to mark the skin where he plans to use the needle. He will then numb the skin at these sites with a tiny needle and local anesthetic. Once numb, he will work with a needle to cut the cords under the skin and reduce the contracture.
  2. What should I do during the procedure? Relax, listen to music and talk as much as you like. The actual procedure is only intermittently uncomfortable. You will need to tell Dr. Stuart if you feel anything painful and, in particular, if you feel any tingling or numbness in your fingertips.
  3. Is it very painful? Usually not. The injections into the skin sting for a few seconds but become numb very quickly. The cords don’t hurt when they are cut. Joints that have been very bent may be painful to stretch out but it subsides quickly.
  4. What will my hand look like after the procedure is over? If all goes well, your fingers should be straighter. The needle entry sites will be covered with bandaids. Ice will be placed on your hand immediately after to prevent swelling and soreness.

Early Aftercare

  1. Day of Procedure
    1. Bandaids can usually be removed and left off later the same day. If you get them wet, remove them and leave them off.
    2. Use: You should be able to use your hand for light activities (eating, getting dressed, and hygiene). You will be able to get it wet in the shower or when washing your hands.
    3. Splinting your hand with a custom brace may be indicated if you have several fingers involved or severe contractures; if it is, Dr. Stuart will have ordered a splint for you prior to leaving after the visit. Otherwise, splinting is seldom needed.
  2. First 48 hours
    1. Ice and elevation are the keys to a painless recovery. On the day of and day after the procedure, keep your hand elevated as much as you can; and use ice or hold something cold every hour for 10 minutes at a time. Avoid swimming or soaking your hand at this time where the hand is submerged for a long period of time.
    2. Washing: You should try to keep your hands dry for a few hours after the procedure.
  3. The First Week
    1. You should avoid strenuous activities with the hand for one week after the procedure. During this time, avoid activities which would make your hands sweaty, grimy, dirty or exposed to harsh chemicals. This is very important to prevent infection.
    2. Medications: Usually there is no need for prescription pain medicine after the procedure. You may use over the counter acetaminophen or ibuprofen as needed.

Follow up

Dr. Stuart’s staff will arrange a follow up appointment for you a few weeks after the procedure.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. There are no stitches to be removed. It is okay to wash the dried blood around your incision with peroxide on sterile gauze.
  3. Elevate your hand above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand.
  4. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Wear the short arm splint for the first 4 weeks after surgery, while you sleep and during the day for activities. After 4 weeks, you may begin to wean from the splint.
  2. Move your fingers frequently, straightening them completely, and making a full fist several times per hours.
  3. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. Pain at the surgical site can occur with direct pressure over the incision, such as that experienced when pushing yourself out of a chair.
  3. Nighttime awakening (related to your carpal tunnel syndrome) usually goes away soon after surgery.
  4. Numbness and tingling may linger for a short while, but improves with time after surgery.
  5. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.
  6. Some people experience pain on either side (or both sides) of the incision around 5-6 weeks after surgery. This is known as “pillar pain”. It results from the new architecture of your wrist after surgery. The pain comes from the “pulling” sensation of the muscles in your hand, since the band that suspended them together has been cut.
  7. Wearing a splint may make your wrist feel “weak”. This is very common but improves as you begin to use your wrist more.
  8. It can take anywhere from 4-6 months to regain strength in the hand after carpal tunnel surgery. Please make an appointment to be seen if you having concerns.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. There are no stitches to be removed. It is okay to wash the dried blood around your incision with peroxide on sterile gauze one time only.
  3. Elevate your hand above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand.
  4. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Wear the short arm splint for the first 3-4 weeks after surgery, while you sleep and during the day for activities.
  2. Move your fingers frequently, straightening them completely, and making a full fist several times per hours. Move your wrist frequently in a directions several times a day.
  3. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. Pain at the surgical site can occur with direct pressure over the incision, such as that experienced when pushing out of a chair.
  3. Numbness may occur around the incision. It will go away gradually as the skin heals.
  4. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.
  5. Wearing a splint may make your wrist feel “weak”. This is very common but improves as you begin to use your wrist more.
  6. You may notice occasional soreness for up to 3 months.

Please make an appointment to be seen if you having concerns.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. There are no stitches to be removed. It is okay to wash the dried blood around your incision with peroxide on sterile gauze.
  3. Elevate your hand above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand.
  4. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Wear the splint for the first 3-4 weeks after surgery, while you sleep and during the day.
  2. Move your fingers frequently, straightening them completely, and making a full fist several times per hours.Do not move your wrist from side to side
  3. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. Pain at the surgical site can occur with direct pressure over the incision, such as that experienced when pushing yourself out of a chair.
  3. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.
  4. Wearing a splint may make your wrist feel “weak”. This is very common but improves as you begin to use your wrist more.

Please make an appointment to be seen if you having concerns.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Do not soak or put the operative elbow in a tub, pool, hot tub, sink or ocean/river/lake for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. There are no stitches to be removed. Leave the steri-strips in place until they fall off.
  3. Elevate your elbow above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative arm.
  4. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Wear the short arm splint full-time for the first 4-6 weeks after surgery, removing only for hygiene. You will need to sleep in it as well.
  2. Move your fingers frequently, straightening them completely, and making a full fist several times per hours. You may gentle bend and straighten your elbow.
  3. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your arm, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. It is common to have pain at the surgical site for several weeks. You will experience improvement in the intensity and frequency of pain but it may take 4-5 months to notice complete pain relief.
  3. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.
  4. Wearing a splint may make your wrist feel “weak”. This is very common but improves as you begin to use your wrist more. You will need to wear the splint for the first 4-6 weeks after surgery to prevent wrist motion that can aggravate the healing tendon at your elbow.
  5. Please make an appointment to be seen if you having concerns.

Diagnosis

The Mallet finger deformity causes a droop of the fingertip. This is caused by an injury to the extensor tendon at the last finger joint. The treatment requires patience and strict adherence to the splinting instructions in order to allow the tendon to heal.

Treatment

You will be sent to Hand Therapy for a “Tip Protector” which is a splint made for you. This splint will keep your fingertip straight. You must wear it full-time for at least 6 weeks – never allowing the tip to bend during that time period. It is important to move the middle joint of that finger while wearing the splint.

What about showers and bathing?

You must wear the splint full time. You may remove the splint to dry your hand. Place your hand flat on a surface, drying the fingertip, without allowing it to bend. Be sure to dry the inside the splint as well.

What about sleeping?

Always wear the splint full time when you sleep. When we sleep, all of us naturally curl up our fingers without realizing it. In fact, after the initial 6-week healing period, you will need to sleep in the splint for another 2 months.

Will I need to go to hand therapy?

Other than having the splint made, you do not need to go to therapy during the 6- week healing period.

What about activity restrictions?

You already know by now that you have to wear your tip protector fulltime. So, no lifting, pushing or pulling is allowed with the affected finger. After the 6-week healing period, you will be given detailed instructions on weaning the splint (with guidance of staff). When you have heavy work to do after the tendon heals, you will need to wear the tip protector for the first month.

How do I wean from the splint?

Weaning will occur after the 6-week healing period and after your follow up visit if you are maintaining extension in the fingertip. For the first 2 weeks after your tendon injury has healed, you may remove the tip protector at home in the evening for 6 hours at a time. You may do normal household activities, but try not to bend the fingertip. If you must do heavy work, you will need to wear the tip protector. Wear the tip protector at night while you sleep.

During weeks 3 and 4, you may do your normal activities without the splint during daytime hours. Again, you must still sleep in your splint. If your occupation requires heavy bending and lifting with your fingers, you should continue to wear the tip protector at work.

At week 5, you may consider sleeping out of the splint every other night. If you are maintaining extension at the tip of the finger, you may continue to sleep out of the splint.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. Stitches will be removed one week after surgery in the office. It is okay to wash the dried blood around your incision with peroxide on sterile gauze one time.
  3. Elevate your hand above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand.
  4. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Move your fingers frequently, straightening them completely, and making a full fist several times per hours.
  2. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. Pain at the surgical site can occur with direct pressure over the incision, such as that experienced when pushing yourself out of a chair.
  3. Numbness and tingling may linger for a short while, but improves with time after surgery.
  4. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.

Please make an appointment to be seen if you having concerns.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Do not soak or put the operative elbow in a tub, pool, hot tub, sink or ocean/river/lake for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. There are no stitches to be removed. Leave the steri-strips in place until they fall off.
  3. Elevate your elbow above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative arm.
  4. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Wear the short arm splint full-time for the first 4-6 weeks after surgery, removing only for hygiene. You will need to sleep in it as well.
  2. Move your fingers frequently, straightening them completely, and making a full fist several times per hours. You may gentle bend and straighten your elbow.
  3. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your arm, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. It is common to have pain at the surgical site for several weeks. You will experience improvement in the intensity and frequency of pain but it may take 4-5 months to notice complete pain relief.
  3. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.
  4. Wearing a splint may make your wrist feel “weak”. This is very common but improves as you begin to use your wrist more. You will need to wear the splint for the first 4-6 weeks after surgery to prevent wrist motion that can aggravate the healing tendon at your elbow.

Please make an appointment to be seen if you having concerns.

Wound Care

  1. Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  2. Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. The stitches will be removed approximately 7-10 days after surgery.
  3. Elevate your hand above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand.
  4. Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Wear the short arm splint for the first 2-3 weeks after surgery, while you sleep and during the day for activities.
  2. Move your fingers frequently, straightening them completely, and making a full fist several times per hours.
  3. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. Pain at the surgical site can occur with direct pressure over the incision, such as that experienced when pushing yourself out of a chair.
  3. Nighttime awakening (related to your carpal tunnel syndrome) usually goes away soon after surgery.
  4. Numbness and tingling may linger for a short while, but improves with time after surgery.
  5. It is common to have mild swelling at the surgical site, but usually is not associated with pain or redness.
  6. Some people experience pain on either side (or both sides) of the incision around 5-6 weeks after surgery. This is known as “pillar pain”. It results from the new architecture of your wrist after surgery. The pain comes from the “pulling” sensation of the muscles in your hand, since the band that suspended them together has been cut.
  7. Wearing a splint may make your wrist feel “weak”. This is very common but improves as you begin to use your wrist more.
  8. It can take anywhere from 4-6 months to regain strength in the hand after carpal tunnel surgery. Please make an appointment to be seen if you having concerns.

  1. Sling: Your shoulder will be in a sling at all times including sleep. You may loosen the sling to straighten your elbow when seated but do not remove and do not move your shoulder.
    1. Most people are more comfortable sleeping in a reclined position after shoulder surgery. A recliner chair is ideal but a bunch of pillows on the couch should work.
    2. At your post-op appointment, we will review surgical findings and discuss duration of sling use.
  2. Dressing: Do not remove the surgical dressing until two full days after your surgery (for example- if surgery is Tuesday, do not remove until Thursday).
    1. Do not shower during the two days the dressing is in place. Once you remove the dressings, you may shower – keep your arm close to your body and do not use it.
    2. There may be bloody drainage on the dressing, which is common. If this occurs, do not remove the dressing – you may reinforce it with gauze and medical tape (obtained from the pharmacy)
    3. After the two days, you may remove the dressing and will see your small surgical incisions. Cleanse gentle with soap and water, do not scrub the area. Once dry, use Band-Aids to cover the incisions. Do not apply any ointment or lotions such as Neosporin or hydrogen peroxide.
  3. Ice: Use ice to help minimize pain and swelling. Use a large bag of ice or frozen vegetables and drape over the shoulder for 20-30 minutes. Do not place directly on the skin but on a towel placed over the shoulder. Ice the shoulder at least 3-5 times daily for at least the first 2-3 days and then as needed.
  4. Pain Management: Most patients receive a “numbing” block duringsurgery. It may provide significant pain relief for 4-12 hours after surgery. It is important to start taking your pain medication as soon as you feel any discomfort. Do not wait until pain is intense – you will have more difficulty controlling pain if you do. You will be given a prescription for pain medication, use as directed if needed.
    1. You may also take one of the following over the counter medications in addition to the prescription: Advil/Motrin/Ibuprofen 400-800mg every 8 hours or Aleve 220-440mg every 12 hours if needed.
    2. Avoid Tylenol if you are taking the pain prescription as it usually has Tylenol combined with a narcotic. You may take Tylenol if you are not taking the pain prescription.
    3. A common side effect of narcotic medications is constipation: start taking a stool softener starting the day of surgery. Colace or Senna are over the counter stool softener found at pharmacies.
    4. Nausea after surgery can be cause by pain medications or anesthesia. If occurs, please notify Dr. Stuart’s office and a medication can be prescribed for it.
  5. Follow up appointment: An appointment for follow up has been made for you.

If you have any questions or concerns prior to then, please don’t hesitate to call 804-320-1339 and ask to speak with Dr. Stuart’s team.

Wound Care

  • Keep your incision dry, but it is okay to take a shower and wash your hands. Please do not put your operative hand in a tub, pool, hot tub or sink of water for 2 weeks after surgery.
  • Keep the surgical wound covered with a band aid or bandage for the first week. Please do not apply antibiotic ointment or use peroxide on the surgical site. It is best to keep the incision dry and change the bandage as needed. It is okay to wash the dried blood around your incision with peroxide on sterile gauze one time. Stitches will be removed 7-10 days after surgery.
  • Elevate your hand above your heart when up. You may cross your wrist over your chest to the opposite shoulder or strike the “Statue of Liberty” pose with the operative hand.
  • Report redness, swelling or drainage to our office at 804-320-1339.

Activity

  1. Move your fingers frequently, straightening them completely, and making a full fist several times per hour.
  2. Refrain from pushing, pulling, lifting or grabbing with the operative hand and do not lift anything that weighs 5 lbs for more. (ex. A gallon of milk weighs 8 lbs)

What should I expect during the first month after surgery?

  1. You should experience minimal pain, which is usually relieved by resting your hand, taking over the counter pain medications such as acetaminophen or ibuprofen.
  2. Pain at the surgical site can occur with direct pressure over the incision, such as that experienced when pushing yourself out of a chair.
  3. It is common to have mild swelling or pain at the middle joint of the operative finger.
  4. The palmar skin is used for our sense of touch. When it is cut, as in surgery, the skin/scars become hypersensitive. Massaging the scars and touching them with different textures helps “desensitize” the skin or return the palm to normal sensation. Vitamin E can be used to soften the scar.
  5. At 6 weeks postoperatively, it is common for the surgical scar to thicken slightly. It will begin to “thin out” over the next few weeks.
  6. Please make an appointment to be seen if you having concerns.