Hand surgery: after-care (Day Surgery Unit)

Looking after your hand

After your operation, we bandage your hand with wool and crepe to protect your wound.

The dressing reduces swelling and makes you feel more comfortable.

To help your recovery, follow this guidance:

• Leave the bandage in place and keep it dry.
• Keep your hand raised, so that your wrist is above your elbow. This is especially important for the first 48 hours after your surgery.
• Do not sit with your hand in your lap. Instead, keep it raised on a few cushions.
• We may give you a sling to help keep your hand raised during the day time.
• At night, position a pillow so that your fingertips are higher than your elbow. This means the swelling in your hand can drain away from the finger tips.

Pain and flexibility

You may experience mild pain or discomfort when the local anaesthetic has worn off. This usually happens 4 to 6 hours after the operation.

We may prescribe painkillers, but most patients do not need them. You can buy over-the-counter painkillers, such as paracetamol, as necessary.

Remember to move your fingers, elbow and shoulder joints to prevent stiffness.

Finger exercises

While wearing your hand bandage, try the following finger exercises as soon as possible:

• straighten your fingers completely
• make a claw and a fist with your fingers
• spread your fingers as wide as possible
• touch each of your fingertips with the tip of your thumb.

We advise you to do these exercises at least 10 times every waking hour. The more you do them, the faster your hand will recover.

Wound dressings and wound site

Dressings

On discharge from hospital, your nurse will advise you on how long your dressings must stay in place. This advice will depend on the surgical procedure you have.

Wound site

In the first week afterwards, the wound is usually slightly bruised and swollen.

Contact our Trauma and Orthopaedic department if you notice any of the following:

• noticeable redness or tenderness
• numbness (lack of feeling), cold or change of colour of your fingers.

These may be signs of infection in the wound site.

Trauma and Orthopaedics:  020 8934 6983 or khn-tr.orthopaedics@nhs.net

Everyday activities

Washing

If we have given you plaster of Paris to keep your hand immobile (not moving), leave the dressings on and keep them dry.  Do this until a doctor or physiotherapist has reviewed your progress at your follow-up appointment. The timing of this appointment will vary, depending on your surgical procedure.

Some patients will see a hand therapist, who will provide a thermoplastic splint to wear as soon as possible (at the latest, two weeks) after surgery. This will be lighter and easier to manage.

Driving and return to work

Our advice on driving will vary, depending on the type of surgical procedure you have. 

For some patients, if they have regained full movement and are reasonably comfortable without the dressings, they may be able to drive a car after one week.

Do not drive while your hand is bandaged and splinted.

Timing of your return to work depends on your occupation. We will have discussed this with you before the operation.

Wound healing

Your wound should heal within 12 to 14 days.

If we have used non-dissolving stitches, the nurse will advise you when and where they will be removed (at your GP or at Kingston Hospital Outpatients). They will discuss this with you before you go home.

If we have used dissolvable stitches, you will need to make an appointment with your GP for a wound check, after 7 to 10 days.

Scarring

Although the wound heals within the first two weeks after surgery, the wound scar will keep changing for up to 6 to 8 months.

In the first 6 weeks it is often pink or red, firm and tender. This is normal. Regular use of an everyday skin moisturiser, combined with simple massaging of the scar, may speed up healing. 

Try to wash the scar with soap and water, and moisturise it, as soon as the wound has healed.