Post-op Instructions for Dupuytren's Open Contracture Release
Wound Care
- Right after your surgery, a bulky dressing (bandage) with plaster splint will be placed on your hand. You will not be able to move your fingers or your wrist while this dressing is on
- You will have your first therapy visit about 3-5 days after surgery. At that visit the bulky dressing will be removed and you will have an extension splint made you only wear at night. Therapy will also manage your incisions if needed and instruct you how to change your dressings.
- Do not soak the incisions in water. When bathing, use a plastic bag over your hand to keep the incisions dry and protect them until the sutures are removed, 2 to 3 weeks after surgery. Most times, we remove only half the sutures at a time so that gaps do not form in the incision.
- Do not put any ointment or lotion on your incisions.
- Your incisions may form some gaps after surgery. Be sure to keep your incisions clean and covered until these gaps have closed.
Pain Management
- You will receive a prescription for narcotic pain medicine. Take this medicine only if you need it.
- Be sure to talk with the clinic nurse about how to take your pain medicine. To best manage your pain, you must take your pain medicine the way it was prescribed. Taking the correct dose at the right time is very important.
- If you have uncomfortable side effects from the pain medicine, call the nurse at 206-598-4263.
- Please see “Medications After Surgery” for more instructions.
Driving
- Do not drive if you are taking narcotic pain medicine. It is not safe. The medicine can make you sleepy and delay your reaction time.
- Once you are no longer taking the medicine, you may drive as soon as you can comfortably grip the steering wheel with both hands.
Occupational Therapy
- One of the biggest concerns after surgery for Dupuytren’s contracture is preventing stiffness of the fingers. To help, we advise starting hand therapy 3 to 5 days after surgery.
- Your therapist will make a splint that helps keep your fingers straight. Wear this splint at night for 3 months.
- Doing things that flex your fingers and making a fist on a regular basis will help prevent stiffness. Your therapist will show you exercises to do at home as part of your daily exercise program.
- You may need therapy sessions for up to 3 months after your surgery. You will likely have therapy once a week for 6 to 8 weeks. If your range of motion is improved at that time, you may see the therapist every 2 weeks for 4 to 6 more weeks.
- If you live nearby, we will try to arrange for you to have your therapy at the Exercise Training Center, which is next to the Hand Center. If you live farther away, we will try to find a therapist in your area.
Follow-up
- When you leave the surgery center, you should have a follow-up appointment in the Hand Center already set for 10 to 14 days after surgery.
- You should also have an appointment after surgery to return for occupational therapy in 3 to 5 days. Please take pain medicine before your first therapy visit. Your dressing will be removed at that time.
- You will need to have many dressing changes and therapy visits in the weeks after surgery. Please avoid planning any trips that take you away from the Seattle area for more than 3 days at a time. Ask your therapist if you have any questions about this.
Activity
After all the incisions have healed, you may increase your activities as tolerated. Heavier activities now will help soften the scar. Your therapist will also give you instructions and supplies to help soften the scar.
Results
Most patients have a big improvement in their finger movement and in most of their finger or thumb contractures after surgery. But, small contractures may still occur, especially for the small finger.