Care after your ulnar nerve transposition
Caring for your wound and surgical dressing
· Keep the surgical dressing on and dry.
· To protect the dressing when you bathe or shower, we recommend a cast cover or a double plastic bag with duct tape. However, you shouldn't immerse the arm in water, even with it protected, as the seal is generally not strong enough to keep the water out.
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· If the dressing gets a little wet, blow air into it with a hairdryer set on "cool" to dry out the padding on the inside. If the dressing gets very wet, it may need to be changed. Please call Dr. Williams' office.
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· Swelling can fluctuate after surgery. If the dressing feels too tight, you may loosen the outer wrap. If it still feels too tight, please contact Dr. Williams' office right away for assistance.
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· The sutures used to close the wound are buried below the skin and do not need to be removed. They will absorb on their own.
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· At your first post-surgical appointment with Dr. Williams, the surgical dressing will be removed. At this point, you may begin getting the wound wet in the shower. After your shower, pat the area dry before applying a new clean dressing. Dr. Williams recommends one or two large Bandaids followed by an ace wrap.
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· Please keep the wound covered until it is no longer tender to the touch and is no longer oozing. 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 sealed.
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· 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.
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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.
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· After surgery, you will be in a bulky dressing that will restrict your use of the arm. You will also be given a sling. Wear the sling for the first 14 days after surgery. Remove your arm from the sling 3-4 times a day to gently bend and straighten your shoulder and elbow a few times to prevent stiffness. The sling can also be removed for showers, to dress, and for computer use. The sling can be removed for sleep if you are a "quiet" sleeper. If you tend to flail around in your sleep (or if you have a sleeping partner who does so), Dr. Williams recommends wearing the sling to sleep for safety. After 14 days, the sling can be discontinued.
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· The sling will restrict your use of the arm after surgery. You may remove the sling to type but otherwise should avoid use of the surgical hand and arm for the first 14 days after surgery. After 14 days, you can use the hand for light activities like eating, shaving, and brushing your teeth. However, do not lift more than the weight of a cup of coffee or do any pushing, pulling, or gripping with the hand until 6 weeks after surgery. 6 weeks after surgery, you may progress your activity gradually according to your comfort level. Painful activity should be avoided. Pain is your body's way of telling you it is not ready yet for what you are asking of it.
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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 2-3 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
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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.
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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.