The vast majority of hand and wrist operations are performed as a day case procedure.
The information below highlights some important points; to ensure you are aware of what an operation on your hand or wrist entails.
It is important to recognise that your hand may be bandaged or put into a plaster cast following your procedure and that you may not be able to use it normally whilst it heals.
It is important to anticipate these potential difficulties, especially if you live alone.
Driving
It’s important not to drive until you are fit to do so. Some post-operative medications and pain may affect your ability to drive safely. Consult the DVLA guidance, your surgeon or GP, and your insurance company for advice on fitness to drive after surgery. Different insurers may have varying policies regarding medical fitness for driving.
Kitchen tasks
Preparing meals after hand surgery can be challenging. We would recommend that meals are perhaps prepared in advance, or even having a supply of microwaveable meals.
Jewellery
Please ensure that you remove all rings and jewellery from the arm that is undergoing the operation. Our hospital policy prohibits performing surgery with any jewellery on the affected side. If you are unable to remove a ring, we recommend seeking assistance from a jeweller to safely cut it off.
When you come to the hospital, you will be admitted to the ward where your details will be confirmed. You will see Mr Harrison and if undergoing a procedure under general or regional anaesthesia, your anaesthetist.
Your Anaesthesia
Many smaller hand and wrist procedures are performed under local anaesthetic. This involves injecting anaesthetic around the site of the operation. You remain awake for the operation.
Some procedures are performed under a regional anaesthetic, in which your arm becomes numb and you are awake for the procedure. Other procedures performed under general anaesthetic means that you are asleep for the procedure. Mr Harrison and the anaesthetic team will discuss this with you.
Your operation
This will take place in the operating room and this can be quite daunting as you walk into an unfamiliar environment. Staff are present to guide you through the process and aim to reduce any anxiety that you may have.
You will be given specific post-operative instructions after your procedure but there is some general advice applicable to all hand and wrist operations.
Wound Care
To facilitate proper wound healing and reduce the risk of infection, it is essential to keep all wounds clean, dry, and covered for ten days following surgery. You will be given an appointment to check your wounds and remove sutures if required about 10 days after your surgery.
If suture removal is required, we recommend keeping the wound covered for an additional two days before exposing it to the air. It’s safe to get the wound wet in a shower two days after suture removal, but avoid soaking in a bath for approximately two weeks. We recommend that you gradually massage the wound and get your joints moving.
During the healing process, you may experience tenderness and itching, which is normal. It can take approximately 6-12 months for the wound to settle into a thin, non-tender, white scar. Numbness near the wound, a result of nerve division, is generally not a major concern but should be considered when dealing with temperature-sensitive objects.
Returning to work
The decision to return to work depends on the type of surgery and your work. There are no strict rules, but if your job or work role involves heavy manual labour, you may require 4-6 weeks off work.
Those with office-based jobs may often return within a few days. Ultimately, the decision is yours, and we offer support as needed. If you require a sick leave certificate, please inform us, and we will arrange it.
The majority of routine surgical procedures are successful, but it’s crucial to be aware of potential post-operative issues. This information below highlights some of the surgical complications and strategies to minimise their impact.
Wound Care
All surgical wounds should be kept clean, dry, and covered for ten days after the procedure. This helps with wound healing and reduces the risk of infection. Typically, the wound heals within two weeks, but it can take six to twelve months to settle into a thin, non-tender, white scar.
Numbness
After surgery, skin surface nerves are often divided in the wound, which may lead to permanent numbness in the area. While this rarely causes significant issues, caution should be exercised when handling hot or cold objects.
Hematoma/Persistent Bleeding
Occasional complications include hematoma (collection of blood) or persistent bleeding after surgery, especially if you are taking aspirin, warfarin, or have a history of difficulty with prolonged bleeding. You may require a change of dressing or, in rare cases, a second operation to address the bleeding. Prolonged bleeding may necessitate an overnight hospital stay, but it usually does not pose a serious threat.
Wound Tenderness
Post-surgery wound tenderness is common and typically resolves within two to three months. In some rare cases, long-term tenderness may persist.
Hypertrophic Scarring
Hypertrophic scar formation is a possibility, leading to wider or lumpy scars. While this can be a cosmetic concern, it is not typically a serious issue.
Hand Stiffness
To prevent stiffness following hand surgery, it is crucial to move the hand early and frequently. Scar tissue can develop over the weeks after surgery, potentially affecting tendons and nerves. Regularly exercising the hand by making a fist and then fully extending the fingers is recommended. Physical hand therapy may be necessary in some cases. Your progress will be assessed during the post-surgery visit, so be sure to discuss any concerns.
Infection
Wound infection occurs in approximately 1 in 100 patients after surgery. Mild redness around the stitches often resolves after suture removal and does not require treatment. Severe cases may necessitate antibiotic treatment or additional surgery, although this is not common.
Nerve and Blood Vessel Injury
There is a risk of nerve or blood vessel injury during arm and hand surgery, which can result in altered sensation or temporary weakness. Permanent damage to a nerve or complete division during surgery is extremely rare but can lead to long-term loss of arm and hand function. Blood vessel injuries, while rare, may require further surgery or, in extremely rare cases, impact finger or thumb blood supply.
Complex Regional Pain Syndrome (CRPS)
CRPS is a rare but severe complication affecting 1 in every 2000 patients following hand or arm surgery. It causes pain, sensitivity, swelling, and stiffness. Treatment involves physiotherapy and medical therapy, but it may take up to two years to improve. Long-term disability is possible in some cases.
Book your consultation with Simon using Spire Healthcare online booking system.
Book your consultation with Simon using Spire Healthcare online booking system.
