Dr Stuart Myers

Hand Surgery General

                                

 

Your Operation:

Most surgery can be performed on a day only basis or with an overnight stay. You will be admitted to hospital on the day of surgery. You should confirm the admission time the day before your scheduled operation.

The anaesthetist will see you before the operation & you should discuss with him any

- previous anaesthetic problems,

- any allergies &

- provide a list of any medications you are taking.

You are advised to stop smoking prior to your operation.

You should not eat or drink anything for 6 hours prior to the time of surgery. The only exception to this is to take your regular medications with a small sip of water.

The operation may be performed under: general, regional or local anaesthetic.

During the surgery a tourniquet is applied to the arm so that there is no bleeding. This allows an excellent view of the area.

       


                                   Tourniquet

Occasionally the findings at operation are unexpected and as far as possible these will be dealt with at the same time.

 

Dr Myers will generally summarise the above issues by highlighting the table below as it applies to YOUR specific operation. eg An Endoscopic Carpal Tunnel Release

 


After the Operation:

When you awake the arm will be bandaged often also with a small plaster slab supporting the wrist.

 

This can often be removed in a day or two and wrist exercises commenced. The arm is elevated in a sling but you can take your arm out of the sling and exercise the shoulder and elbow to prevent stiffness. If at any time you think the dressings or plaster are too tight please elevate the arm & let the nurses or your surgeon know immediately.

You will be given painkillers if needed. Pain management after hand surgery is very important and often surgery is performed under an Axillary Block as well as General anaesthetic to provide excellent post operative pain control.

Where possible the dressings will be made as light as possible both for comfort & to facilitate movement.

For smaller dressings not requiring plaster immobilisation a Cutiplast adhesive waterproof dressing  or a Bandaid will be applied so that you can have a shower.

                   

Otherwise wounds should be kept dry. You should not have a soaking bath or go swimming until the dressing and sutures are removed after approximately 7 - 10 days. It is not uncommon for the wound to ooze under the dressings but if this is excessive the dressings may require changing.

The time and date for follow up after your surgery will be provided on your operation report and on   the envelope with your Operation Report. A copy of the report will be given to you before you leave hospital for your records.  Often a second report is provided to be given to the Hand Therapist if needed.

You must NOT drive yourself home. You should go home with friends or in a taxi with another person.

Swelling & stiffness are best avoided and so elevation in a sling, ice packs and gentle exercise particularly of the fingers are encouraged.


Pain:

In general the pain gradually subsides following surgery. This is usually relieved by simple analgesics such as Panadeine or Panadeine forte. If the pain is progressively increasing in severity then please contact your surgeon. Elevating the arm above the level of the heart for 48 - 72 hours after the operation can relieve pain.


Complications:

(Anaesthetic, Medical, Surgical)

The commonest complication after hand surgery is excessive swelling resulting in the dressings or plaster becoming too tight. In general if the plaster feels too tight it is.

Other complications are rare but include: bleeding, infection, stiffness, irritable or raised scars, neuromas, vessel or tendon damage, chronic pain syndromes, over or under correction of a deformity, and others.
Particular operations may entail specific risks and so please feel free to discuss these with your surgeon. Occasionally symptoms can be made worse by the surgery. Any of these complications may require further treatment or surgery.

If you are concerned that there is a problem then contact your surgeon through the office. If it is out of hours you should phone the hospital where the surgery was performed and ask them to contact Dr Myers. If he is unavailable the hospital can contact one of his associates.



Recovery after Surgery:

It will take time to regain full use of your hand after surgery. With some simple preparation, routine tasks during the days following your surgery need not be difficult.
The recovery time from different operations varies greatly so discuss this with your surgeon.

Put all regular medications in bottles with regular caps. Childproof caps will be hard to open with one hand. Make sure you keep them well away from children.

Prepare foods that do not require both hands to cut and eat. You might consider investing in an electric can opener so only one hand is needed to open cans for you or your pets.

You should not drive while in a plaster. In general you have to be able to save yourself or someone else in an emergency & so pain should not be so severe that you could not turn the steering wheel rapidly. Remember that someone else should drive you home from the hospital even if you have had a local anaesthetic.

 

Clothing

-Wear clothes that you can put on yourself. Avoid buttons & zippers where possible.

-Avoid long sleeves if you will have a bulky dressing or cast.

-Slacks with elastic waistbands may be easiest to manage.

-Slip-on shoes will be easier than laced shoes

-Women should consider bras that fasten down the front & avoid pantyhose

-Avoid jewellery especially in hospital

-You may want to replace contact lens with eyeglasses until you hand is able to manage contacts


Operations on the Dominant Hand:

-It may be difficult to write after the operation so consider completing important documents prior to the surgery

-Initially it may be difficult to toilet yourself so consider practising with your other hand prior to the operation