Care after your rotator cuff repair

Caring for your wound and surgical dressing

· Keep the surgical dressing on and dry for 3 days.  During this time, you may sponge bathe only.

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· After 3 days, you may remove the outer surgical dressing and begin getting the wounds wet in the shower once a day. After your shower, gently pat the wounds dry.

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· After your remove the outer surgical dressing, you will see steri-strips over the wounds. Leave these in place until they fall off on their own. You will not see stitches. They are buried below the skin and will absorb on their own. After the steri-strips fall off, if the wounds are still tender or oozing, cover them with bandaids. If not, they may be left open to air. Do not apply any lotions/salves/ointments until the skin has completely healed.

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· You may not immerse the surgical area in water (such as tub baths, swimming, and hot tubs) until you have been cleared by Dr. Williams to do so.

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Activity after surgery

· You will be placed in a sling after surgery. You must wear the sling at all times, even when sleeping, until follow-up. You are allowed to move the hand, wrist and elbow while wearing the sling, but only for light activities such as eating or writing. You may also remove the sling to shower, but do not move the shoulder and do not reach, lift, push or pull anything with the operative arm.

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· You may start shoulder pendulum exercises the day after your surgery. You will receive a sheet with instructions. These exercises should be done 4 times a day, for about 5 minutes each time.

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· Most patients find that it is most comfortable to sleep in a semi-upright position such as in a recliner after surgery. You can also use the couch or bed while propped up on some pillows or a foam sleeping wedge. This is usually necessary for several weeks after surgery. 

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· Your arm will be in a sling for 6-8 weeks after surgery. We do not recommend that you drive while your arm is in the sling.

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Managing your pain after surgery

· Ice can be very helpful after surgery. Ice your shoulder 20 minutes at a time, 4 or more times a day. To avoid injury, place a towel over any areas of exposed skin first so the ice is not in direct contact. A cold therapy machine such as those made by Breg, Iceman, and Donjoy is highly recommended. These are not always covered by insurance. If you choose to purchase one on your own, they usually cost around $150-200. Sometimes a friend or neighbor will have one you can borrow.

 

· 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. 

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Follow-up care

· You will have a follow-up appointment with Dr. Williams 1-2 weeks after surgery to check your healing. You will begin physical therapy after this appointment. 

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When to call your surgeon

· If you experience any fevers, chills, increasing wound drainage, redness, pain that is not controlled, swelling that is not controlled, or problems with your dressing, wound, or sling, or if you have any other questions or concerns, please call Dr. Williams’ office.