Care after your wrist ganglion excision
Caring for your wound and surgical dressing
· You will be placed in a splint after surgery to reduce swelling and lower the chance of the cyst returning. Leave the splint on for the first five days after surgery. It must stay clean and dry.
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· To protect the splint when you bathe or shower, we recommend a cast cover or a double plastic bag with duct tape. However, you shouldn't immerse the splint 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 splint gets a little wet, blow air into it with a hairdryer set on "cool" to dry out the padding on the inside. If the splint gets very wet, it may need to be replaced. Please call Dr. Williams' office.
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· If there is a spot where your splint is rubbing on/irritating your skin, please call Dr. Williams' office. We will work with you to fix the problem.
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· Swelling can fluctuate after surgery. If the splint feels too tight, you may loosen the ace wrap. If it still feels too tight, please contact Dr. Williams' office right away for assistance.​
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· After five days, you may remove the splint and outer surgical dressing and begin getting the wound wet in the shower once a day. After your shower, pat the wound dry and apply a new dressing.
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· After your remove the outer surgical dressing, you will see steri-strips over the wound. 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.
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· Please keep the wound covered until it is no longer tender to the touch and is no longer oozing. Dr. Williams recommends applying an adhesive bandage and then wrapping a self-adhesive wrap (e.g. two inch 3M Coban wrap) on top of the adhesive bandage. Whatever you choose should be changed regularly and kept clean and dry. Do not apply any lotions/salves/ointments until the skin has completely healed.
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· 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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· Immediately after surgery, you can use the hand for light activities like eating, shaving, typing, and brushing your teeth. 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. 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. It may take a couple of months before you are able to fully return to some of the most intense activities, like pushups and repetitive heavy lifting.
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· Move move move those fingers! Moving your fingers during the recovery period is critical to avoid stiffness. We encourage range of motion of the fingers during the recovery period as it will help prevent stiffness. If you are not able to make a full fist or extend your fingers fully by a week after surgery, please call Dr. Williams's office, and we will arrange for you to visit with one of our hand therapists.
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· A wrist brace is not required after surgery but may be worn for comfort if desired once the surgical splint is removed. For most patients, Dr. Williams discourages wearing the brace continuously for more than 2 weeks, as this can lead to stiffness.
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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.