Is erythema and edema of the volar aspect of my fifth digit 25 days after contracture release surgery, while performing prescribed range‑of‑motion exercises, normal?

Post-Operative Finger Contracture Release: Assessment at 25 Days

At 25 days post-surgery, persistent redness and swelling of your pinkie finger—while performing prescribed exercises and regaining motion—likely represents normal postoperative inflammation rather than infection, provided you have no fever, purulent drainage, or worsening pain. 1

Key Distinguishing Features

Signs That Suggest Normal Healing (Your Situation)

• Swelling and redness present but stable or slowly improving 1
• No fever (temperature remains below 38.5°C/101.3°F) 1
• No purulent (pus-like) drainage from the incision 1
• Progressive improvement in range of motion with exercises 1
• Absence of severe, worsening pain 1

The Infectious Diseases Society of America guidelines explicitly note that "flat, erythematous changes can occur around or near a surgical incision during the first week without swelling or wound drainage" and that "most resolve without any treatment, including antibiotics." 1 While your timeline extends beyond one week, the same principle applies when systemic signs are absent.

Red Flags Requiring Immediate Medical Evaluation

You should contact your surgeon urgently if any of the following develop:

• Fever ≥38.5°C (101.3°F) 1
• Heart rate ≥110 beats per minute 1
• Erythema (redness) extending >5 cm from the wound edge 1
• Purulent drainage (thick, cloudy, or foul-smelling fluid) 1
• Increasing pain rather than gradual improvement 1
• White blood cell count >12,000 cells/µL (if labs are checked) 1

Expected Timeline for Hand Surgery Recovery

Swelling after hand surgery typically persists for 2-4 weeks and resolves gradually with elevation and prescribed exercises. 1 The presence of ongoing edema at 25 days—particularly on the volar (palm-side) aspect where surgical dissection occurred—is common and does not automatically indicate infection. 1

Normal Post-Operative Course

• Days 1-7: Physiological swelling is expected and considered normal 1
• Days 8-30: Persistent swelling should be monitored but often resolves with conservative measures (elevation, exercises) 1
• Beyond 30 days: Persistent swelling warrants re-evaluation for underlying pathology 1

Recommended Management Strategy

Continue Current Conservative Measures

• Maintain prescribed range-of-motion exercises as demonstrated by your provider 1
• Elevate the hand above heart level when resting to facilitate drainage 2
• Apply ice or cold therapy for 15-20 minutes several times daily to reduce inflammation 2

Monitor for Progression

Schedule a follow-up with your surgeon within 48-72 hours if:

• Redness or swelling increases rather than stabilizes 1, 3
• New symptoms develop (fever, drainage, severe pain) 1
• You have concerns about the healing trajectory 3

When Antibiotics Are NOT Needed

The 2014 Infectious Diseases Society of America guidelines are clear: if erythema and induration measure <5 cm from the wound edge AND you have no systemic signs (fever <38.5°C, pulse <110 bpm), antibiotics are unnecessary. 1 Opening the wound is only indicated if there is purulent material to drain. 1

Common Pitfalls to Avoid

• Do not assume all redness equals infection. Surgical inflammation can persist for weeks, especially in areas with significant soft tissue manipulation like the finger. 1
• Do not stop exercises prematurely due to mild swelling. Controlled motion is essential for preventing re-contracture and promoting lymphatic drainage. 1
• Do not delay evaluation if warning signs appear. While most post-operative swelling is benign, infections that do occur after day 4-7 require prompt assessment. 1

Special Considerations for Finger Surgery

Hand and finger procedures carry unique healing characteristics:

• Dependent positioning (hand hanging at your side) worsens edema; consistent elevation is critical 2
• Volar (palm-side) incisions often show more prolonged erythema due to thicker dermis and greater mechanical stress during hand use 1
• Active motion exercises may transiently increase local redness due to increased blood flow—this is therapeutic, not pathologic 1

Your regained motion is the most reassuring sign that healing is progressing appropriately. 1 Continue your exercises, maintain elevation, and monitor for the specific warning signs outlined above. If symptoms remain stable or improve over the next week, no intervention beyond your current regimen is needed.