From the Guidelines
The patient should receive comprehensive education on post-operative care, including wound management, pain control, and physical therapy, to optimize recovery and minimize complications, as emphasized by the most recent guidelines 1.
Post-Operative Care
The patient should keep the surgical site clean and dry for the first 48 hours. The dressing should remain in place until the follow-up appointment, typically scheduled 7-10 days after surgery.
- Pain management should include acetaminophen 650 mg every 6 hours as needed, and if prescribed, an NSAID like ibuprofen 400-600 mg every 6 hours with food, as recommended by recent studies 1.
- The hand should be elevated above heart level using pillows when resting to reduce swelling.
- Limited finger movement is encouraged to prevent stiffness, but the patient should avoid heavy lifting (anything over 5 pounds) and strenuous activities for at least 4-6 weeks.
Patient Education
Adequate education for the patient and, if possible, of the family about the surgical and anesthesiologic treatment, options, plan, and aims of pain management should be performed whenever it is possible, as highlighted by recent guidelines 1.
- Patient education should include information on:
- Wound care and dressing changes
- Pain management and medication use
- Physical therapy exercises to prevent stiffness and promote recovery
- Signs of infection and when to seek immediate attention
Follow-Up Care
The patient should expect some numbness and tingling during the healing process, which typically improves gradually over several weeks to months as nerve function recovers. Complete recovery may take 3-6 months, with gradual return to normal activities as directed by the surgeon.
- Physical therapy exercises will likely begin after the first follow-up appointment, and the patient should be encouraged to attend these sessions to optimize recovery, as recommended by recent studies 1.
From the Research
Post-Operative Patient Education
The patient, a 51-year-old male who underwent surgery for right hand carpal tunnel, cubical tunnel, and trigger finger repair, requires proper post-operative care to ensure optimal healing and prevent complications.
- Wound infection is a significant concern, as it can lead to delayed healing, chronicity, and increased healthcare costs 2.
- Early identification and management of wound infection are crucial to promote faster wound healing and reduce the risk of negative outcomes 2.
- The clinical nurse plays a vital role in assessing changes in the patient's skin and initiating wound care, and practical guidelines are available to support this process 3.
Wound Care and Management
- Simplifying wound care to enable patient or family delivery is essential, and telemonitoring can help reduce the frequency of interventions by a visiting nurse or wound care center 4.
- Defining patient expectations is critical to designing a successful treatment plan, and patient outcomes may include wound-specific outcomes, such as time to heal, wound size reduction, and improvement in quality of life 4.
- A comprehensive understanding of wound healing, including the classical wound healing phases, is necessary to identify potential alterations that may promote chronic wound development and impede wound healing 5.
Infection Control and Wound Cleaning
- Proper wound cleaning, suturing, and infection control are essential in primary care management of wounds, and nurse practitioners should be aware of recent changes in infection control techniques and their impact on wound care 6.
- The patient should be educated on proper wound care, including cleaning, dressing, and monitoring for signs of infection, to ensure optimal healing and prevent complications.