Post Surgery Instructions
Here are the general recommendations for most hand, wrist, and elbow surgeries.
Your particular instructions may vary depending on your case and surgeon preferences. After surgery you will be given an informational handout with specific instructions for your case. These instructions are meant to in general and not specific to your case. Please contact us if you have questions 919-872-3171.
- Hand Elevation: Keep your hand elevated above your heart after surgery for the first few days. Keep a pillow under your hand while sleeping to keep it elevated. If the hand is lower than the heart it will often swell after surgery
- Remove the shoulder sling: Do not use a sling for prolonged periods of time after hand, wrist or elbow surgery as it can result in hand swelling and shoulder stiffness. Wean out of the sling when the nerve block wears off.
- Keep the surgical bandages dry: Cover the bandages with a plastic bag secured with rubber bands or tape while showering.
- Hand activity: If the fingers are not immobilized by the bandages, you should gently make a fist and straighten the fingers several times per day to reduce stiffness. However, if the fingers are immobilized in a splint, you should rest the hand and avoid movement of the fingers. No heavy use with the hand until notified by the doctor.
Reasons to call the office:
Call the office if you have severe pain, severe swelling, bleeding, vomiting, fever greater than 101 degrees F, wound drainage, or concerns for infection. Some amount of pain, swelling and bruising is normal after surgery. Call the office if your fingers appear to lose blood flow or circulation. 919-872-3171
Hand numbness: Numbing medicine is often used during surgery which can cause the hand and arm to be numb for 24 hours after surgery.
Tight bandages: If the bandage feels too tight, it may be gently loosened. If this does not help, please notify us. Take care not to move the plaster splint if this is included in the bandages.
No smoking: Do not smoke or use tobacco products. Nicotine can reduce blood flow to the hand and delay healing.
No neosporin: Do not use ointments such as neosporin or antibiotic creams on the incision. Keep the incisions covered with a bandage until the sutures are removed in the office.
Water: Do not submerge the incisions under water, such as in a bath, hottub, or pool. Avoid getting dirty water on the surgical area such as dishwater or ocean water. Your surgeon may allow you to get the incision wet briefly while in the shower.
Pain Medications: Wean off opioid pain medications as soon as possible. Plan ahead to avoid running out of pain medication at night and on weekends, as these will not be refilled after regular office hours.
Guide to Pain Management
You will be given an instructional handout after surgery regarding pain management. Below are general recommendations for most patients. Your particular case may vary depending on surgeon preference and your health history.
- Rest: relax, take breaks, and do not overuse the hand or arm for the first few days after surgery. The worst pain only lasts for the first 48 hours and improves significantly after that.
- Ice: apply ice to the area 15 minutes at a time. Repeat several times per day as necessary. Avoid ice directly on the skin.
- Elevation: elevate your hand to the level of your heart or higher to reduce swelling.
Take over the counter medications: If approved by your primary care physician, purchase the following over the counter medications:
- Ibuprofen (Advil or Motrin) 200 mg
- Tylenol (acetaminophen) 500 mg
Combine Tylenol and Ibuprofen: These medications work better together to make each other stronger. This is a case of 1 + 1 = 3 (Not 2!)
For up to 7 days most adults can take:
- 500 mg Tylenol, up to 6 doses in 24 hours
- 600 mg Ibuprofen, up to 4 doses in 24 hours
*** Caution is advised in patients with kidney disease, GI bleeding, liver disease, recent heart procedures, and those who take blood thinners ***
Sample dosing schedule:
- 6 AM Ibuprofen 600 mg
- 9 AM Tylenol 500 mg
- Noon Ibuprofen 600 mg
- 3 PM Tylenol 500 mg
- 6 PM Ibuprofen 600 mg
- 9 PM Tylenol 500 mg
*** You may take one extra dose of 500 mg Tylenol and 600 mg Ibuprofen if you wake up with significant pain at night.
Take medications before going to sleep: did you have a nerve block and your hand is still numb at bedtime? Take Tylenol AND ibuprofen before going to bed and before the hand wakes up. This will decrease the pain when the numbing medicine wears off. It is easier to stay ahead of the pain than try to catch up.
If the pain is not controlled with the above plan, take the prescription opioids ONLY for severe pain. Some prescription opioid medications are combined with Tylenol (such as Percocet, Norco, and Lortab Rx). Avoid more than 3000 mg of Tylenol in a 24 hour period. Reduce the intake of these medications as the pain subsides. Opioid medications can result in addiction, problems breathing, overdose, and death.
If this plan does not control your pain, please call our office.
Disclaimer: The information provided on this page and website is intended for general information only and does NOT constitute medical advice. The medical content on this website is for current RHSC patients ONLY.
