Care after your Dupuytren's fasciectomy
Caring for your wound and surgical dressing
· Keep the surgical dressing on and dry until your visit with hand therapy. At your hand therapy visit, the surgical dressing will be removed and you will receive a custom splint. You will wear the custom splint at night for the first 3 months after surgery.
​
· After the surgical dressing has been removed, you may begin getting the wound wet in the shower once a day. After your shower, pat the wound dry and apply a new dressing.
​
· The wound will be closed with external stitches. These are usually removed by Dr. Williams or by a hand therapist 10-14 days after surgery.
​
· Please keep the wound covered until the sutures have been removed. You will receive instructions on wound care at your first hand therapy visit. The dressing should be kept clean and dry. Do not apply any lotions/salves/ointments until the skin has completely healed.
​
· Avoid prolonged immersion of your incision in water (such as tub baths, swimming, hot tubs, and dish washing without gloves) until the wound has healed.
​
· After the skin has healed, it will take some time for the swelling to resolve and the scar to mature. Dr. Williams recommends applying Vaseline or Aquaphor and gently massaging the scar 3-4 times a day for a few minutes at a time to aid in scar tissue breakdown.
​​​
Activity after surgery
· Elevation above the level of your heart will help with pain and swelling. A cold pack may also help. It can be used every 1-2 hours for 20 minutes at a time. Be sure to place a thin towel between the cold pack and exposed skin so that they are not in direct contact.
​
· Immediately after surgery, you will be in a dressing that will limit use of your hand. Once the surgical dressing has been removed, some patients are able to use the hand for light activities like eating, shaving, typing, and brushing their teeth right away. For others, it may take a week or two. Listen to your body and avoid painful activity. It is your body's way of telling you that it is not ready yet for what you are asking of it. Do not lift more than 2 pounds or do forceful gripping with your hand until the wound has healed. After the wound has healed, you may progress your activity gradually according to your comfort level.
​​​
Managing your pain after surgery
· Some discomfort is expected after surgery but with the proper pain control measures, the amount of pain you have can be greatly decreased. We recommend Tylenol and Ibuprofen so long as these medications are safe for you. If you do not know whether these medications are safe for you or if you have had a bad reaction to acetaminophen, ibuprofen, aspirin, or other non-steroidal anti-inflammatory medications (NSAIDs) in the past, please discuss with your primary care doctor before taking them.
· If you are able to take these medications safely, we suggest taking Tylenol and Ibuprofen regularly during daylight hours beginning as soon you get home and continuing for at least the first 1-2 days after surgery. After that point, just take these medications as needed. These medications can be taken together and work together to make each other stronger. These medications should not be taken at the same time as other medications containing acetaminophen, ibuprofen, or other NSAIDs. Please refer to the instructions on the bottle for dosing instructions.
Do NOT take more than 3,000 mg Tylenol in 24 hours
Do NOT take more than 2,400 mg of Ibuprofen in 24 hours
· Dr. Williams may prescribe you a narcotic pain medication after surgery. If so, it is a good idea to take it with food to avoid nausea. Do NOT use alcohol or drive while using narcotic pain medication, as these activities can lead to serious injury or death. Refills of prescription medication cannot be called in to your pharmacy. These must be sent electronically and can only be sent during normal business hours. Please keep track of how many pills you have left and provide 24-hours notice if you require a refill, keeping in mind that the office closes for the weekend at 4 pm on Fridays.
​
Follow-up care
· You will have an appointment with a hand therapist within the first week of surgery to take your surgical dressing down, receive a custom splint, and, in most cases, begin range of motion exercises. You will also have a follow-up appointment with Dr. Williams 10 to 14 days after surgery to check your healing and remove your sutures if the wound is sufficiently healed. If you have difficulties scheduling a hand therapy appointment, please call Dr. Williams' office for assistance.
​​
When to call your surgeon
· If you experience any fevers, chills, increasing wound drainage, pain that is not controlled, swelling that is not controlled with elevation, or problems with your dressing or wound, or if you have any other questions or concerns, please call Dr. Williams’ office.