Trigger Finger/Thumb Release Post-operative Care

The following are post-operative instructions for patients who have undergone trigger finger or thumb release. 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) 879-2663.

DRESSINGS:
You will have a compressive dressing. Although it is very unlikely, you may notice some bloody spotting coming through the outer dressing. 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 nylon, a non absorbable suture. The sutures will need to be removed. Usually, we removed the sutures when you follow-up in the office. This can occur as early as seven days but usually 7-10 days after surgery.

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 hand above the level of your heart. You can keep ice packs on the palmar side of the dressing for 20 minutes at a time, three-six times per day during the first few days without risk of frostbite injury to
the underlying skin as long as the original dressings are in place. You do not need to use ice if you dont want to. I feel that elevation is more important than icing due to the thickness of the dressings.

SHOWERS:
You can remove your dressings to shower 2 days following surgery (i.e., surgery on Wednesday shower on Friday). Remove the dressings to the sutures, shower, allow the wound to dry. Apply a light gauze dressing or Band-Aid. You can repeat this routine daily until follow-up. If you’re more comfortable leaving the dressing on that is okay. Simply keep the 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.

PHYSICAL THERAPY:
In general the recovery from trigger finger/thumb release is rapid and can be accomplished with home exercises and theraputty for strengthening. If you prefer a prescription for formal therapy please let us know. Most people do not need formal physical therapy.

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 like eating, drinking, and using a computer, but do not lift anything heavier than a glass of water until the sutures have been removed by Dr. Sarin or his nurse practitioner. I do not want you to do any heavy lifting, pushing or pulling until the wound heals.

OFFICE FOLLOW-UP:
You will receive a call the day after your surgery, and the first post operative visit will be scheduled at that time unless instructed otherwise after surgery.

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 are welcome to use an over-the-counter anti-inflammatory such as Ibuprofen (Advil, Nuprin, etc.). These come in 200-mg tablets. The usual adult prescription dosage is 600-800 mg up to three times per day, usually taken with food.

This would amount to taking 9-12 store tabs per day. The anti-inflammatory medicine can be taken on a regular basis along with the prescription pain medication, which is utilized on an as needed basis. You will find that the combination will lessen your need for the prescription pain pill. If you have a history of ulcers or of stomach irritation with aspirin or anti-inflammatory drugs, then you should avoid using an anti-inflammatory.

Avoid taking any Tylenol with the hydrocodone or oxycodone. These two medications generally have Tylenol added in. If you’re not using hydrocodone or oxycodone you may use plain Tylenol alone. Plain tylenol is OK if you have no liver disease. Remember, the short acting pain pills often have acetaminophen (Tylenol) in them. The maximum daily
dose of Tylenol if you have a normal liver is 3500-4000 mg. If you have a history of nausea with surgery we can prescribe a anti nausea medication (Phenergan). Try to take this medication regularly at first and prior to taking the narcotic pain pills to allow it to be most effective.

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. We strongly discourage calls for refills after business hours or on weekends.

COMPLICATIONS:
Trigger finger/thumb release surgery is a fairly simple and minimally invasive outpatient surgery, so postoperative complications are fortunately 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 with any concerns at
970-879-2663 or 855-969-2663.