Please protect you splint / dressings at all times and carry out gentle activities only until instructed otherwise (usually 6-8 weeks)
Children may go to school when able, but should avoid any sports/gym etc. and always wear the polysling provided (see below).
Do not get you splint or dressings wet as this may allow bacteria to get to the surgical site and cause infection.
Following hand or arm surgery there will be a tendency for swelling. This delays recovery because of stiffness and may slow healing. Furthermore swelling will make your bandages or splint tight and this can be very uncomfortable. It is therefore very important that you elevate your hand or arm at all times for the first 5-7 days.
If your hand starts to throb or you can feel it becoming tighter you should immediately start elevating it even after this time.
Usually, even after things have settled down when you start to use your hand again you will get periods of time when it starts to swell. This can last for a few months but will eventually settle. It is important when this happens that you keep your hand elevated afterwards to allow swelling to settle and in some cases you may need to reduce the activity with your hand if swelling persists.
For smaller operations you will be provided with a poly sling by the nurses on the ward. This should position your hand above the level of your heart (which is in the centre of your chest), so a position with your fingertips touching the opposite shoulder is ideal. If your hand is below your heart in the horizontal position some swelling will still occur, so please ensure that your sling is tightened to the right level.
If you are having more involved hand surgery you will also be supplied a foam splint called a Bradford sling, this is useful as it provides some padding, but also can be propped up between pillows or against the side of a chair and automatically keeps the arm elevated at the right level when you are lying down. This is useful therefore to wear at night but you can wear this during daytime as well if you find it comfortable.
When your dressings are removed your wound is not necessarily strong so it is important that you continue to take things gently until you reach at least 2 weeks from the date of your surgery. At this point the skin is usually strong enough for day to day activities but depending on your surgery the internal tissues may still require protection, for example tendon repairs may take 8 weeks or longer before they reach full strength. You will be advised about this of course in your clinic follow ups.
Once your dressings have been removed you may wash your hands in running water and after a few days you may soak the hand as normal. You will find that skin has accumulated on your wounds and this can be gently peeled off if it is removed easily. If it is still quite stuck down wait a few days, soak the hand and try again. Eventually all affected skin will peel off leaving a healed wound underneath.
Following hand surgery you may find that your wounds and scars are very sensitive. This is because the skin of the hand has a high density of nerve endings to allow it to function. The tiny ends of these are irritated at surgery and can become sensitive. It is important that you desensitise these and this can be achieved simply by regular massage. This should be carried out every day once your dressings have been removed and your wounds are healed. A moisturiser is used to help and firm pressure needs to be applied once the wounds are strong enough.
Exercises are a vital part of the post-operative care following hand surgery. The hand has a tendency to swell and become stiff following surgery and exercises directly counteract this. The timing of exercises depends on the type of surgery you have had and the need to protect repairs. I will guide you on this in your clinic appointments. When shown exercises by either myself or our therapists, it is important that you carry them out as often as you have been asked to do as this tends to ensure a faster recovery.
Exercises are of 2 types: the most important exercises in the early stages of your post-operative time are called range of motion exercises. The purpose here is to get the joints to move through the full range possible but not to load the fingers by using weights or carrying anything heavy. These are good for getting rid of swelling and stiffness,
The second type of exercise is loading or resistance exercises and our Team will guide you on the right time to carry these out.
Antibiotics are important following some types of surgery and if you are prescribed these please take them exactly as recommended. Please let me or our staff know if you have any allergies to antibiotics.
Strong painkillers are usually prescribed for the first 2-5 days following surgery and after this simple painkillers such as paracetamol usually suffice. In the first day or so after surgery it is often better to take your painkillers regularly as prescribed as this will keep you more comfortable. After this time you may decide to take your painkillers as required.
The above instructions provide a general guide only and I will go through any specific instructions for you at clinic. Always ask if you have any questions about any particular aspects of your care.
Please try to keep strictly to your follow up appointments as I use these to check on your progress and to ensure that you are not getting stiff and you scars are not getting sensitive following your hand surgery. It is also a chance for you to ask questions and to assess how well your condition has responded to surgery. Please always let us know if you cannot make an appointment well in advance so that we can reschedule your appointment.
If you have any problems please contact the nurses at the hospital on 0161 495 7023. The nurses have direct contact with our Team and can clarify things over the phone or make arrangements for you to be seen urgently if this is necessary