ENDOSCOPIC CARPAL TUNNEL RELEASE SURGERY   additional POST OPERATIVE INSTRUCTIONS  for DR. WINT

KEEP  THE OPERATIVE SPLINT ON YOUR HAND UNTIL  YOU ARE SEEN IN THE OFFICE FOR YOUR  FIRST FOLLOW-UP VISIT

MOVE YOUR FINGERS, ELBOW AND ARM AND USE YOUR FINGERS

    YOU MAY USE YOUR FINGERS TO DO ACTIVITY BUT AVOID OVERDOING IT TO THE POINT WHERE YOU ARE INCREASING YOUR PAIN A LOT.

    DISCOMFORT WHEN YOU MOVE YOUR FINGERS IS NORMAL. HOWEVER YOU NEED  TO  MOVE YOUR FINGERS

    YOU SHOULD MAKE A FIST THEN RELAX AND EXTEND OR STRAIGHTEN YOUR FINGERS TO GET MOVING EVERYDAY THROUGHOUT THE DAY

    THE GOAL IS TO HAVE FULL PAIN FREE MOTION OF YOUR FINGERS  SO  THAT WHEN YOU RETURN TO THE OFFICE THE FIRST VISIT  IT'S NOT A PROBLEM

    YOU MAY USE YOUR HAND. THE SPLINT  AND DRESSING  FROM THE  OPERATING ROOM IS THERE TO PROTECT YOUR PALM.

     JUST DON'T OVERDO  IT TO THE POINT THAT PAIN IS INCREASING

    ICE AND ELEVATION HELP TO REDUCE SWELLING. FOLLOW THE ADDITIONAL INSTRUCTIONS YOU HAVE BEEN GIVEN PRIOR TO DISCHARGE

    DO NOT KEEP YOUR ARM OVER YOUR HEAD. KEEP A PILLOW ON YOUR CHEST TO KEEP YOUR HAND HIGHER THAN YOUR HEART.

    ICE CAN BE APPLIED USING AN ICE PACK OVER THE DRESSING. EVEN ICE TO THE BACK OF THE WRIST AND HAND  HELPS.

    BEFORE YOUR FIRST POST OPERATIVE VISIT YOU MUST KEEP YOUR DRESSING DRY UNTIL IT IS CHANGED OR REMOVED IN THE OFFICE. FOR SHOWERS OR BATHS KEEP YOUR DRESSING COVERED WITH A PLASTIC BAG

AT THE FIRST POSTOPERATIVE APPOINTMENT THE SUTURES  ARE TYPICALLY REMOVED.

YOU THEN NEED TO USE A REMOVABLE SPLINT AND YOU WILL BE FITTED FOR ONE IF YOU DON'T HAVE A SUITABLE ONE

BRING A SPLINT IF YOU HAVE IT AND WANT TO USE IT AND ITS IN GOOD CLEAN SHAPE

TO CARE FOR YOUR INCISION AFTER YOUR FIRST POSTOPERATIVE VISIT IF YOUR SUTURES ARE OUT

     SHOWER AND BATHE  AND GET YOUR HAND WET BUT AVOID  OVER SOAKING OR SCRUBBING THE  INCISION REALLY HARD

     IT'S NORMAL FOR THE SKIN AT THE INCISION TO DRY CRACK AND PEEL. IF IT DOES YOU CAN USE SOME CREAM OR LOTION, WHATEVER BRAND YOU CHOOSE. THERE IS NOTHING

     SPECIAL ABOUT ANY ONE BRAND FOR THIS, IF YOU WANT TO  USE WAL-MART OR CVS TYPE HAND CREAM THAT'S FINE TOO.

    HOWEVER IF THE SKIN ISN'T DRYING OR CRACKING THEN YOU DON'T NEED TO PUT LOTION OR OINTMENT ON THE INCISION.

    TOO MUCH MOISTURE FROM TOO MUCH OINTMENT OR CREAM CAN MACERATE OR IRRITATE   THE SKIN

    A SMALL BAND-AID CAN BE WORN ON THE INCISION FOR A FEW DAYS TO AVOID IRRITATION  TO THE INCISION FROM THE SPLINT. CHANGE THE BAND AID REGULARLY

REMOVABLE SPLINT WEAR AFTER FIRST POST OPERATIVE VISIT  THERE ARE 2 MAIN IDEAS 

1.DAYTIME  5/10/15      2. NIGHTTIME SLEEPING

THE FIRST WEEK APPROXIMATELY 5 HOURS OFF IN TOTAL DURING THE DAY ( NOT 5 HOURS IN A ROW, BUT A HOUR HERE OR THERE FOR A TOTAL OF 5 HOURS)

THE NEXT WEEK APPROXIMATELY 10 HOURS OFF DURING YOUR ACTIVE  AWAKE DAY

THE NEXT WEEK APPROXIMATELY 15 HOURS OFF...

BY THE END OF THE 3RD WEEK MOST PEOPLE ARE COMFORTABLE ENOUGH IN MOST SITUATIONS WHERE THEY ARE NOT USING A SPLINT AT ALL EXCEPT MAYBE IN CERTAIN SITUATIONS. YOU MUST USE YOUR JUDGMENT FOR THIS. (SOME GO A LITTLE FASTER SOME GO A LITTLE SLOWER BUT THIS IS A GOOD GUIDELINE THAT WORKS FOR MOST PEOPLE)

WHEN YOU HAVE FINISHED DAYTIME SPLINTING, TYPICALLY IN ABOUT THREE WEEKS THEN IF YOU ARE COMFORTABLE YOU CAN STOP NIGHT TIME OR SLEEP TIME SPLINTING AS WELL.

ON FOLLOW-UP IN 4 - 5 WEEKS AFTER THE SURGERY SOME WILL STILL HAVE SOME DISCOMFORT IN THE MIDDLE OF THE PALM TO VERY DEEP PRESSURE BUT BROAD FLAT PRESSURE AND NORMAL GRASPING CAN BE DONE WITHOUT A SPLINT.  SOME HEAVIER JOBS OR HOBBIES STILL REQUIRE A SPLINT FOR SOME OF THE ACTIVITIES SUCH AS A NEOPRENE SOFT SPLINT OR RARELY THE RIGID SPLINT BUT THIS IS NOT TYPICAL,  YOU DO NOT WANT TO WEAR THE SPLINT TOO LONG BEYOND THE TYPICAL DAY OR NIGHT PHASE AS SOMETIMES THE REVERSE HAPPENS AND INSTEAD OF THE SPLINT PROTECTING YOU FROM DISCOMFORT IT STARTS TO RUB ON THE SKIN AND IRRITATES IT

ANY QUESTIONS ? CALL THE OFFICE!

ADDITIONAL INFORMATION: VIEW THE MATRIX

JCW 4/2010