Hand and Upper Extremity Post Operative Instructions
Following surgery, a post-operative appointment should be scheduled 7-10 days after surgery. Dr. Lin will discuss the nature of your surgery, all the findings, and detailed post-operative treatment course when you come in for your first post-operative checkup.
Most frequently asked questions are answered below. If you have any other questions do not hesitate to call Dr. Steven D. Lin’s office, (626) 821-0707 from 8am to 5pm. After hours the call center can get you in touch with the on-call physician.
• Pain is usually one of a patient’s first thoughts about surgery: How much is it going to hurt? Everyone experiences pain differently and to different degrees, but be assured that we will do our best to keep you comfortable. It is normal to have some post-operative pain. Typically, pain is the worst for the first 3 days then it gradually decreases in the following days. Take your prescribed pain medications as directed.
• For many procedures, the anesthesiologist may offer a regional nerve block. It is an injection in the upper shoulder/arm area that can temporarily (12-24 hours) block out all sensation to the limb. This is beneficial in two ways: 1) Less anesthetic gas during the procedure => less post-operative recovery time. 2) No immediate post-operative pain, allowing the patient to stay on top of controlling pain symptoms with oral medications as the nerve block slowly wears off.
• At the end of your surgery, you may also have a local anesthetic injected at the surgical site to keep the area numb. This usually lasts a few hours, and as you start to gain feeling back, you may start to feel pain. Stay ahead of this by taking the prescribed pain medications, following the instructions on the bottle.
• An ice pack may be applied over the dressings to help with pain and swelling. It is important to keep the dressings dry, and not allow the moisture from the ice pack to get the dressings wet.
• Keeping the operative extremity elevated above the heart will help with post operative swelling/pain.
• Swelling is expected following surgery. Reducing swelling helps speed recovery and will decrease pain.
• Elevation is the best remedy to swelling. Keep your hand elevated above the level of your heart for 3‐5 days. While sitting in a chair or lying in bed, place your arm on pillows raised above your heart, with your finger‐tips pointing towards the ceiling.
• While walking around, keep your hand elevated on your opposite shoulder. Raise your hand straight above your head for 60 seconds 5 times a day. You may discontinue elevation when lowering the hand no longer causes it to throb. This typically happens after 72 hours.
• Gentle hand movement is encouraged as your bandage allows, trying to open and close your hand helps eliminate swelling.
• Bruising is common following surgery. It may travel down your arm over the next few days (from gravity and elevating your arm). This is normal and comes from absorbed blood seeping through the tissues. The bruising usually resolves a few weeks after surgery.
• The post-operative dressing, splint, or cast is a very important part of your treatment. Keep the dressings clean and dry. The dressing should be left intact until your post-operative visit, unless specified in detailed postoperative instructions.
• Frequently splints and casts will feel too tight, and you are welcome to loosen the outer compression (tan colored) wrap, but please do not remove the entire dressing or adjust the plaster of any splint.
• Place a large plastic bag over your dressing/splint when you shower or bathe to prevent it from getting wet. Place two rubber bands above the dressing/splint to keep the bag in place and to avoid leaking. Keep the operative site out of the stream of the shower.
• In general, care should be taken within the first several days following surgery to limit any strenuous activity. Elevations of heart rate and blood pressure can increase swelling and discomfort.
• Throughout the day, you should gently open and close the fingers to avoid them from getting stiff. Do not lift anything with the operative side.
• Fevers and chills could be a sign of post-operative infection. If you think you may have a fever, use a thermometer to take your temperature. Call our offices if your temperature is greater than 101.5°F.
• Pain medication is frequently prescribed, and specific details regarding these medications can be addressed by your pharmacist.
• In addition to prescribed pain medication, over‐the‐counter medicines have been shown to be quite effective in pain mediation. (Tylenol, Advil, Motrin, Aleve) can be taken every 4-6 hours as needed.
• Pain medications can sometimes cause nausea, constipation, and itching. These are frequent “side effects” but rarely constitute a true allergy. Any new rash difficulty with breathing, or swelling of the lips and face may indicate a serious allergic reaction, and you should alert your doctor