Cambridge Plastic Surgery

Plastic and reconstructive surgery, hand surgery and aesthetic surgery

Medicolegal reporting

 

 

Post-operative instructions after minor hand surgery

 

  • The area of surgery could be numb for 3-5 hours. In some patients, areas of numbness will persist for several days after surgery.
  • You should elevate your hand for at least the first 24 hours after surgery.
  • If your hand becomes very swollen or if the dressings feel very tight and constrictive, then immediately loosen the dressings.
  • Dressings should usually be left intact until the wound is checked. You will need to be careful when washing.
  • If your hand is supported by a splint after surgery, (for example after tendon surgery): this will need to stay in place until the first dressing change. For some patients a splint will need to remain in place for several weeks.
  • Post-operative pain is usually controlled with a combination of paracetamol, ibuprofen, or cocodamol (co-codamol is 15mg codeine, and 500 mg paracetamol). Do not exceed the recommended daily intake of ibuprofen or paracetamol.
  • Hand wounds are usually closed with absorbable sutures. The sutures do not dissolve, but usually fall away after about two weeks. The wounds are not sutured tightly in-order to allow excess fluid to escape into the dressings.
  • Most hand wounds take more than 2 weeks to heal. You should expect dressing to be needed for at least 2 weeks.
  • Infections after hand surgery are rare, but need rapid treatment. Signs of infection include: Swelling, increasing redness, pus or bleeding, the wound feeling warm, an unpleasant smell, increasing pain, or fever. If you think you have an infection after surgery, you can contact the private hospital for advice (they usually contact me), you could arrange an urgent appointment to see your GP, or call NHS direct for advice.
  • Sepsis after hand surgery is extremely rare, but if untreated it can be devastating. Signs of sepsis include high fever, or low body temperature, chills and shivering, patches of discoloured skin, raised heartbeat, or fast breathing. If you have any of the features of sepsis, you should phone NHS direct as soon as possible, or urgently attend a local hospital emergency department.
  • You should not drive until confident and safe to do so, please look at the DVLA website, please discuss driving with your car insurance provider. Do not expect to drive home after surgery.
  • Your hand is likely to be weak for 6 weeks or more, your hand is likely to be uncomfortable in cold-weather for several weeks after surgery.
  • Wounds heal and become scars: most scars are firm and uncomfortable for the first few months after surgery. Moisturiser can be firmly massaged into the scar twice per day to help the scar soften. Loose skin around the edge of a hand wound may flake away in the weeks after surgery.
  • The timing of your return to work is dependent upon the work environment, the intensity and length of duties, and the extent and anatomical location of surgery. Many patients will discuss this with an employer before surgery. I can also issue you with a fitness for work certificate to cover a period of sick leave. 
  • Please discuss with me any plans to return to competitive sport.

 

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