Hand Section  of  drdcunningham.com

Post Operative Instructions

                                         General


Elevation of the hand is very important after any surgery or injury to the hand. The hand should be kept at a level that is higher than your heart in order to cause fluid to drain from the hand. This is very important to prevent swelling. A swollen hand will be painful, and a swollen hand will also become stiff. It is important to make a full fist and fully straighten your fingers ten times an hour after any hand surgery or injury that does not involve a tendon repair. This motion will pump the fluid out of the fingers and thereby prevent swelling.

Do not change the bandages or splint after surgery until the first post operative visit with Dr. Cunningham.  The bandages must also be kept dry. Showering should be done with a large plastic bag over the hand and arm, securely taped just below the shoulder. By keeping the hand fully elevated, it is possible to take a brief shower without getting the bandages wet. Better still there are available from medical supply stores cast or dressing protectors that are designed to protect a cast or dressing

After an operation that has been done under a local anesthetic, or local anesthetic with sedation, it is common to experience numbness and tingling in the hand for eight to ten hours or longer. A prescription for a pain reliever will be given to you after the surgery and we recommend that you fill the prescription, although frequently only one or two pills will be necessary. The most important aspect of pain relief after hand surgery is strict elevation of the hand.

Stitches are usually removed approximately 2 weeks after hand surgery. It may  be necessary to continue with dressings afterwards for a short period of time. Every patient requires a mobilization program which will be initiated once the sutures are removed

Hand therapy may be necessary after surgery for a variety of reasons. Making a special splint, regaining motion, managing scars, etc. are all areas that a Hand Therapist can help with.
                                                  

 

 


Dupuytren`s Surgery

Specific Instructions following Dupuytren`s Surgery

Elevation,
Elevation of the hand is very important after Dupuytren’s surgery. The hand should be kept at a level that is higher than your heart in order to cause fluid to drain from the hand. This is very important to prevent swelling as a swollen hand will be painful, and it will also become stiff. After the splint is removed at the first postoperative visit, a range of motion program will be started and light use for activities such as eating, dressing and personal care. Driving is allowed once you feel strong enough to safely grip the steering wheel.

Dressings
Do not change the bandages or splint after surgery until the first post operative visit. If the palm has been left open, instructions on how to change the bandage will be given at that time. The bandages must also be kept dry. Showering should be done with a large plastic bag over the hand and arm, securely taped just below the shoulder. By keeping the hand fully elevated, it is possible to take a brief shower without getting the bandages wet.

Medication
After an operation that has been done under a local anaesthetic, or local anaesthetic with sedation, it is common to experience numbness and tingling in the hand for eight to ten hours or longer. A prescription for a pain reliever will be given to you after the surgery and we recommend that you fill the prescription, although frequently only one or two pills will be necessary. The most important aspect of pain relief after hand surgery is strict elevation of the hand.

Sutures
Stitches are usually removed 2 weeks after hand surgery.  A massage and exercise program is continued for at least one month. The use of a gentle hand crème such as lanolin  compounds is recommended thickened and tender scar will frequently develop four weeks after  surgery. You will notice pain primarily with direct pressure on the scar that will slowly resolve over several months.
 

Exercise and return to work

You will be given simple exercises to perform to assist you in getting the hand functioning normally. Depending on the individual and on the severity of the disease it may be necessary to arrange for Physiotherapy to assist in mobilizing the hand. This is usually decided at the time of the follow up visit after surgery. The period of time required before returning to work will depend on the progress of the healing and on the type of work . It is always preferable to return to work progressively and starting with light duty if you normally do heavy work.

 

 

 


Specific Instructions following trigger finger release

Trigger Finger

Elevation

Elevation of the hand is very important after trigger finger release surgery. The hand should be kept at a level that is higher than your heart in order to cause fluid to drain from the hand. This is very important to prevent swelling as a swollen hand will be painful, and it will also become stiff. After the dressing is removed at the first postoperative visit, a range of motion program will be started and light use for activities such as eating, dressing and personal care. Driving is allowed once you feel strong enough to safely grip the steering wheel.
 

Dressings

Usually a small dressing only is applied. The wound should be kept clean and dry until the dressing is changed by the nurse or the doctor. If the dressing becomes wet it is better to change the dressing yourself and inform the doctor's office of any problems.

Sutures are usually removed at the first post -operative visit which is at approximately 2 weeks following the surgery. Medications are normally required for the first few days only. Take any prescribed medication or Tylenol. Exercise and return to heavy work should be discussed with the doctor

 

 

 


Carpal Tunnel

Specific Instructions following Carpal Tunnel release

Elevation,
Elevation of the hand is very important after Carpal Tunnel Release surgery. The hand should be kept at a level that is higher than your heart in order to cause fluid to drain from the hand. This is very important to prevent swelling as a swollen hand will be painful, and it will also become stiff. After the dressing is removed at the first postoperative visit, a range of motion program will be started and light use for activities such as eating, dressing and personal care. Driving is allowed once you feel strong enough to safely grip the steering wheel.

Dressings
Do not change the bandages or splint after surgery until the first post operative visit. If the  The bandages must also be kept dry. Showering should be done with a large plastic bag over the hand and arm, securely taped just below the shoulder. By keeping the hand fully elevated, it is possible to take a brief shower without getting the bandages wet. Medical supply stores carry protective sleeves to make it more convenient to shower .

Medication
After an operation that has been done under a local anaesthetic, or local anaesthetic with sedation, it is common to experience numbness and tingling in the hand for eight to ten hours or longer. A prescription for a pain reliever will be given to you after the surgery and we recommend that you fill the prescription, although frequently only one or two pills will be necessary. The most important aspect of pain relief after hand surgery is strict elevation of the hand.

Sutures
Stitches are usually removed 2 weeks after hand surgery.  A massage and exercise program is continued for at least one month. The use of a gentle hand crème such as lanolin  compounds is recommended thickened and tender scar will frequently develop four weeks after  surgery. You will notice pain primarily with direct pressure on the scar that will slowly resolve over several months.
 

Exercise and return to work

You will be given simple exercises to perform to assist you in getting the hand functioning normally. Depending on the individual and on the severity of the disease it may be necessary to arrange for Physiotherapy to assist in mobilizing the hand. This is usually decided at the time of the follow up visit after surgery. The period of time required before returning to work will depend on the progress of the healing and on the type of work . It is always preferable to return to work progressively and starting with light duty if you normally do heavy work.

Recovery

With the blood flow to the median nerve restored, the symptoms of burning and tingling are usually relieved soon after surgery. Patients can expect soreness from the incision for 4 - 6 weeks and discomfort from deep pressure for as long as several months. Improvements in strength and sensation depend on the extent of the nerve damage prior to treatment. Normal grip strength may not return for several months following surgery. The natural healing process and regeneration of nerve fibers will occur throughout the following six months to a year.
 

 

 


Ganglion Excision

Specific Instructions following Ganglion Excision

Elevation,
Elevation of the hand is very important after  ganglion excision surgery. The hand should be kept at a level that is higher than your heart in order to cause fluid to drain from the hand. This is very important to prevent swelling as a swollen hand will be painful, and it will also become stiff. After the dressing is removed at the first postoperative visit, a range of motion program will be started and light use for activities such as eating, dressing and personal care. Driving is allowed once you feel strong enough to safely grip the steering wheel.

Dressings
Do not change the bandages or splint after surgery until the first post operative visit. If the The bandages must also be kept dry. Showering should be done with a large plastic bag over the hand and arm, securely taped just below the shoulder. By keeping the hand fully elevated, it is possible to take a brief shower without getting the bandages wet. Medical supply stores carry protective sleeves to make it more convenient to shower .

Medication
After an operation that has been done under a local anaesthetic, or local anaesthetic with sedation, it is common to experience numbness and tingling in the hand for eight to ten hours or longer. A prescription for a pain reliever will be given to you after the surgery and we recommend that you fill the prescription, although frequently only one or two pills will be necessary. The most important aspect of pain relief after hand surgery is strict elevation of the hand.

Sutures
Stitches are usually removed 2 weeks after hand surgery. A massage and exercise program is continued for at least one month. The use of a gentle hand crème such as lanolin compounds is recommended thickened and tender scar will frequently develop four weeks after surgery. You will notice pain primarily with direct pressure on the scar that will slowly resolve over several months.

Exercise and return to work
You will be given simple exercises to perform to assist you in getting the hand functioning normally. Depending on the individual and on the severity of the disease it may be necessary to arrange for Physiotherapy to assist in mobilizing the hand. This is usually decided at the time of the follow up visit after surgery. The period of time required before returning to work will depend on the progress of the healing and on the type of work . It is always preferable to return to work progressively and starting with light duty if you normally do heavy work.
Recovery
 Patients can expect soreness from the incision for 4 - 6 weeks and discomfort from deep pressure for as long as several months. Improvements in strength and sensation depend on the extent of the surgery and the location of the cyst.  Normal grip strength may not return for several months following surgery. The natural healing process and regeneration of nerve fibers will occur throughout the following six months to a year.

 

 

 


Injuries

Specific Instructions following Injuries and repair

The most common procedures in hand surgery are those done to repair injured hands, including injuries to the tendons, nerves, blood vessels, and joints; fractured bones; and burns, cuts, and other injuries to the skin. Modern techniques have greatly improved the surgeon's ability to restore function and appearance, even in severe injuries.

Among the techniques now used by plastic surgeons:

Grafting - the transfer of skin, bone, nerves, or other tissue from a healthy part of the body to repair the injured part;
Flap surgery - moving the skin along with its underlying fat, blood vessels, and muscle from a healthy part of the body to the injured site;
Replantation or transplantation - restoring accidentally amputated fingers or hands using microsurgery, an extremely precise and delicate surgery performed under magnification. Some injuries may require several operations over an extended period of time.
In many cases, surgery can restore a significant degree of feeling and function to injured hands. However, recovery may take months, and a period of hand therapy will most often be needed (see Recovery and rehabilitation below.)

Specific Instructions following treatment of injuries
Elevation of the hand is very important after trauma surgery. The hand should be kept at a level that is higher than your heart in order to cause fluid to drain from the hand. This is very important to prevent swelling as a swollen hand will be painful, and it will also become stiff. After the splint is removed at the first postoperative visit or later as determined by the nature of your injury, a range of motion program will be started and light use for activities such as eating, dressing and personal care. Driving is allowed once you feel strong enough to safely grip the steering wheel.

Dressings
Do not change the bandages or splint after surgery until the first post operative visit. If a wound has been left open, instructions on how to change the bandage will be given at that time. The bandages must also be
kept dry. Showering should be done with a large plastic bag over the hand and arm, securely taped just below the shoulder. By keeping the hand fully elevated, it is possible to take a brief shower without getting the bandages wet.
 
 Medication
After an operation that has been done under a local anaesthetic, or local anaesthetic with sedation, it is common to experience numbness and tingling in the hand for eight to ten hours or longer. A prescription for a pain reliever will be given to you after the surgery and we recommend that you fill the prescription, although frequently only one or two pills will be necessary. The most important aspect of pain relief after hand surgery is strict elevation of the hand.
 
 Sutures
 Stitches are not usually removed before 2 weeks after hand surgery.  A massage and exercise program is continued for at least one month. The use of a gentle hand crème such as lanolin  compounds is recommended thickened and tender scar will frequently develop four weeks after  surgery. You will notice pain primarily with direct pressure on the scar that will slowly resolve over several months.

Exercise and return to work

You will be given simple exercises to perform to assist you in getting the hand functioning normally. Depending on the individual and on the severity of the injury it may be necessary to arrange for Physiotherapy to assist in mobilizing the hand. This is usually decided at the time of the follow up visit after surgery. The period of time required before returning to work will depend on the progress of the healing and on the type of work . It is always preferable to return to work progressively and starting with light duty if you normally do heavy work.

 

 

 


Tenosynovitis

(de Quervain`s)

Specific Instructions following Release of Tenosynovitis

Elevation,
Elevation of the hand is very important after surgery to release stenosing tenosynovitis The hand should be kept at a level that is higher than your heart in order to cause fluid to drain from the hand. This is very important to prevent swelling as a swollen hand will be painful, and it will also become stiff. After the dressing is removed at the first postoperative visit, a range of motion program will be started and light use for activities such as eating, dressing and personal care. Driving is allowed once you feel strong enough to safely grip the steering wheel.

Dressings
Do not change the bandages or splint after surgery until the first post operative visit. If the The bandages must also be kept dry. Showering should be done with a large plastic bag over the hand and arm, securely taped just below the shoulder. By keeping the hand fully elevated, it is possible to take a brief shower without getting the bandages wet. Medical supply stores carry protective sleeves to make it more convenient to shower .

Medication
After an operation that has been done under a local anaesthetic, or local anaesthetic with sedation, it is common to experience numbness and tingling in the hand for eight to ten hours or longer. A prescription for a pain reliever will be given to you after the surgery and we recommend that you fill the prescription, although frequently only one or two pills will be necessary. The most important aspect of pain relief after hand surgery is strict elevation of the hand.

Sutures
Stitches are usually removed 2 weeks after hand surgery. A massage and exercise program is continued for at least one month. The use of a gentle hand crème such as lanolin compounds is recommended thickened and tender scar will frequently develop four weeks after surgery. You will notice pain primarily with direct pressure on the scar that will slowly resolve over several months.

Exercise and return to work
You will be given simple exercises to perform to assist you in getting the hand functioning normally. Depending on the individual and on the severity of the disease it may be necessary to arrange for Physiotherapy to assist in mobilizing the hand. This is usually decided at the time of the follow up visit after surgery. The period of time required before returning to work will depend on the progress of the healing and on the type of work . It is always preferable to return to work progressively and starting with light duty if you normally do heavy work. Also it is important to avoid work or other activities that require repetitive movement.
Recovery
 Patients can expect soreness from the incision for 4 - 6 weeks and discomfort from deep pressure for as long as several months.   Normal grip strength may not return for several months following surgery. The natural healing process and regeneration of nerve fibers will occur throughout the following six months to a year.
 

 

 

Dr David Cunningham   ....  3535 Blvd. St- Charles,
suite 510  .Kirkland, Qc.
H9H 5B9
514 694-1425