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We will give you specific instructions, but in general you may need to:
You will be checked in by a nurse, and see the surgeon and anaesthetist (if you are having a general or regional anaesthetic). We will make sure we have answered any additional questions you have and ask you to re-sign your consent document. We will put a mark on the limb or finger we are going to operate on with a marker pen. We may get you changed into a gown and then walk you down to the operating theatre or procedure room. Bring some slippers or indoor shoes to wear!
This depends on the procedure. Most hand procedures are done under local anaesthetic (numbing just the hand and arm), while others may require general anaesthetic or regional (being asleep or the arm numb). We will discuss what’s best for you with you, and there is a choice if you particularly wanted to be awake or asleep.
Local anaesthetic procedures typically take 10-30 mins, General anaesthetic procedures 60-90 mins. There is some time setting up, putting on antiseptic liquids and drapes to cover you and performing checks before the actual procedure begins. We advise that you are likely to be with us for 2-3 hours .
The local anaesthetic that I use is usually long acting, which means it works for up to 18 hours. This is with the aim of keeping you very comfortable in that early period . After that simple over the counter pain killers like Paracetamol or Ibuprofen are usually enough and most people will take them for a few days to a week. If you know that you are susceptible to experiencing a lot of pain you can let us know and we can prescribe you something to take home.
This varies by procedure, For local anaesthetic carpal tunnel or trigger finger procedures the bandage can come off after 2 days. For Dupuytren's and thumb base surgery you will have dressings on for 2 weeks. Splints are given to help support you getting back to normal activities for some of the bigger procedures and you do not normally need to wear them 24/7. You will usually take them off to do your exercises several times a day and gradually wean off the splintage as you feel more and more comfortable.
For carpal tunnel and trigger finger procedures these can be taken out by the nurse at you doctors surgery, or you can have dissolvable sutures which drop out on their own. For Dupuytrens surgery and thumb base surgery you come to us to manage the dressings and wounds and the stitches are taken out at about 2 weeks.
Most patients do not need formal Hand Therapy, but have self directed exercises and we provide instructions about these and scar management. For more complex procedures our hand therapist always checks in with you and will pick up and treat anyone who is not making the expected progress.
Most people do not drive for a week or two after surgery. There are no rules about this but you need to be confident that you have enough grip to control the vehicle and would not hesitate in an emergency situation. This will vary depending on what type of car you drive, which hand you have had operated on and what operation. For some joint replacement procedures I do not recommend driving for 4-6 weeks.
This will depend on the surgery, and the type of work that you do and how you get to work. It may be 6-8 weeks for more complex procedures but for minor procedures and if you do predominantly office based work then 2 weeks may be enough. We will provide you with a "fit note" to cover any period of work absence.
Once your dressings are off and if the wound is clean and dry you can wash it and pat it dry. This is a minimum of about 5 days. After this, even if you have stitches in there is no evidence that leaving it open to the air or getting it wet (not soaking) increases the risk of infection. Until the dressings or bandage are off though keep your hand covered with a plastic bag or cover which you can buy online.
There are always risks with any procedure, but complications do not happen very often. The most common problems that people experience are: swelling, bleeding, scar problems, infection. Operations may have specific but rare risks like damage to nearby important structures such as nerves, tendons or arteries, or for joint replacements, loosening or dislocation. We will go through the potential risks with you to ensure you understand them. My patient information leaflets on here will describe the risks of each procedure.
The aim of surgery overall is to improve your symptoms whether they are pain, tingling, stiffness, loss of use. Surgery may not make your hand "normal again" and a very small number of people would feel that overall they were no better or even worse off.
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