Hand surgery

The Dignity Health Medical Foundation plastic and reconstructive surgeons treat a wide variety of hand conditions, repairing hands damaged by illness or accident, repetitive stress or other hand conditions.

When you have difficulty using your hands it can affect all aspects of your life. You use your hands to perform nearly every daily task, from caring for yourself and your family and working, to personal enjoyment such as art, gardening and other hobbies. Because the anatomy of the hand is complicated, it is important that you choose a surgeon that has special training in hand surgery.

Conditions treated by our Dignity Health Medical Foundation’s plastic and reconstructive surgeons include:

• Carpal tunnel syndrome
• Contracture release
• Fractures and dislocations
• Ganglion cysts/mucous cysts
• Infection
• Lacerations
• Miscellaneous masses
• Nerve repair and nerve grafting
• Syndactyly release
• Tendon transfers
• Tendon/ligament repair
• Trigger fingers
• Dupuytren's contracture (non-surgical treatment option)
  • Dupuytren's disease is a benign process which causes contracture, or scarring, of the tissues just under the skin in the hand. This process starts as small lumps and bumps in the palm, but can progress to the point where your fingers are bent and cannot be straightened.
  • Treatment for Dupuytren's disease is based on releasing the contracted tissue to allow you to straighten your fingers and improve your ability to use your hand. Historically, the only effective treatment options were surgical. Recently, the FDA approved an injection treatment that may be useful for some patients. This medication, Xiaflex, dissolves the contracted tissue. Treatments may need to be repeated once a month for up to three months.

If you have a SPLINT (plaster or fiberglass) wear your splint AT ALL TIMES! This is imperative to allow for proper healing and to ensure the best functional outcome. Your surgeon or hand therapist will remove your splint at the appropriate time.

If you have a SOFT DRESSING (ACE wrap, gauze etc.) you may remove the dressing in 2 days or you may leave it on. If you remove it, it is OK to shower or wash your hands. Apply bacitracin antibiotic ointment to the incision afterward. You may leave the incision open to air or re-bandage it, whichever is more comfortable.

• Keep your hand elevated above your heart at all times for the first 3-4 days after surgery. This will decrease swelling and minimize pain. Slings are OK, but they usually do not elevate the hand higher than your heart.
• Keep the splint clean and dry at all times. Showering is OK if the splint is protected by a plastic bag or similar device.

• If you have severe or increased pain not relieved by medication
• If you have loss of feeling or motion
• If your fingers turn white or blue, or feel cool to the touch
• If you have increased redness along the incision
• If you have an oral temperature over 101  degrees
• If you have any yellowish or greenish drainage from the incisions or notice a foul odor
• If you have bleeding from the incisions that is difficult to control with moderate pressure

Sutures are usually removed from the hand 2 – 3 weeks following surgery. This will be done when you see your surgeon, or may be done by the hand therapist.

Hand therapy is the single most important component of your recovery and rehabilitation. Therapy may include hand exercises, heat and massage therapy, electrical nerve stimulation, traction, splints and special wrappings to control swelling. The Hand Rehabilitation Center office will contact you to schedule your first post-operative visit, at which point the incision will be checked and a different splint may be made. The success of your rehabilitation depends mostly on you and your ability to follow the instructions and exercises provided by your therapist

Do not resume or begin smoking (or using other nicotine products) after surgery. This can reduce the oxygen in your blood and greatly impact your ability to heal. While it is advised for your overall health that you quit smoking entirely, it is imperative that you do not smoke whatsoever until your incisions have fully healed.