Carpal Tunnel Release Post-Operative Care

The following are post-operative instructions for patients who have undergone carpal tunnel release of their wrist. Please refer to this reference sheet, which should probably answer most of the questions you might have. If you have further questions that need immediate answering, contact our office at (970) 879-BONE (2663)

DRESSINGS:
You will have a bulky dressing and splint. Although it is very unlikely, you may notice some bloody spotting coming through the outer Ace wrap. It is important for you to watch this area, and contact us if it continues to spread. Otherwise, any small area of spotting will dry and can be ignored until you remove the dressings.

SUTURES:
The suture utilized in closing the wound is a nylon, non-absorbable suture. You are NOT to remove these sutures under any circumstance. The sutures will be removed by your doctor or their staff in the office. This usually occurs 7-10 days after surgery but may be longer and this is okay.

ELEVATION AND ICE:
Elevation will help minimize the pain and swelling after surgery, especially during the first few days. Elevation, to be effective, involves keeping your wrist above the level of your heart. You can keep ice packs on the palmar side of the splint continually during the first few days without risk of frostbite injury to the underlying skin as long as the original dressings are in place. I feel that elevation is more important than icing due to the thickness of the splint and dressings.

SHOWERS:
You can remove your dressings to shower 5 days after the surgery. (Surgery on Wednesday:shower on Sunday). Remove the dressings to the sutures, shower, allow the wound to dry. Apply a light gauze dressing or large Band-Aid and the Ace wrap if desired. You can repeat this routine daily until follow-up. If you’re more comfortable leaving the dressing on that is okay. Simply keep the splint and dressing from getting wet during showering by elevating your arm. If there is any noticeable or persistent drainage from the incision site, or any surrounding red areas, please contact us immediately.

FIRST OFFICE VISIT AFTER SURGERY:
We try to schedule your first post-operative visit prior to your arthroscopic surgery. If you do not, we call all patients the day after your surgery and your first post-operative visit can be scheduled at that time. This first visit is usually two or three days after your surgery. If you live very far away, special consideration is given and other arrangements can be made (e.g. you live in the Winter Park, Granby, Craig or Kremmling area).

OCCUPATIONAL THERAPY:
In general the recovery from carpal tunnel release is rapid and can be accomplished with home exercises. Therapy is rarely needed. If you prefer a prescription for formal therapy, please inform the physician or their nurse.

USE OF THE HAND:
Unless instructed otherwise, we encourage you to increase motion of your fingers as soon as possible, within your comfort range. You can use the hand for routine activities. I do not want you to do any heavy lifting, pushing, or pulling until the wound heals.

MEDICATIONS:
You will be provided with a prescription for a pain medication when you are ready to leave the hospital. Usually we will prescribe Hydrocodone or Oxycodone. These are both generic names for two different narcotic pain relievers. If you are aware of a certain pain medication that you have previously had problems with, or one that you normally respond favorably to, please inform us so that we can give you the appropriate prescription. You may have the prescription prior to surgery to avoid filling it the day of surgery. You might also be given a prescription for an anti-inflammatory medication Toradol (ketorolac) that will help lessen pain and swelling. Tylenol and Acetaminophen are the same medicine. You should not use Tylenol if you are using the Percocet/Roxicet or Lorcet prescription medications since they already contain tylenol/acetaminophen. If in doubt check the prescription label to be sure acetaminophen is not in your medication. We try and avoid over-the-counter anti-inflammatory medications such as Ibuprofen (Advil, Aleve, Nuprin, etc.). If you have a history of ulcers or of stomach irritation with aspirin or anti-inflammatory drugs, then you should avoid using Toradol. Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. I cannot provide prescription refills after business hours or on weekends, so please plan ahead.

COMPLICATIONS:
Carpal tunnel release surgery is a fairly simple outpatient surgery, so postoperative complications are quite rare. The incidence of an infection deep within the hand is literally one out of thousands. Onset of symptoms would be approximately 5-7 days following surgery, and would consist of a significant increase in pain, swelling, warmth, and redness of the hand, wrist, or forearm, fever, chills or night sweats. More common, but still quite rare, would be a small superficial infection or irritation at the skin incision.

Contact our office for any concerns at 970-879-BONE (2663).