Postoperative Protocol

We will see you back in the office approximately ten days after surgery for dressing and suture removal.  Steri-strips will be placed across your wound.  These will come off in 7-10 days on their own, or you can peel them off when they start to come off.  You will often be placed in either as splint or a cast, depending upon the nature of your surgery.  If you are out of a cast you can shower tomorrow. 

Frequently, occupational therapy will be instituted at the same times to help restore the range of motion and strength in those areas of your hand or arm that were not immediately involved in surgery.

Peak Reaction:  Healing of the incision is a continual process of remodeling and body healing.  Four to six weeks after surgery our wound reaches what we call “peak reaction".  What this means is that the wound will look its worst at this time, being raised, purplish and swollen.  From six weeks on, the wound will continue to mature and its appearance will become less and less obvious.

Plateau Phase:  Therapy involves a gradual remodeling process, and you will reach what we term the “plateau phase.”  Initially, you will notice significant improvements of your motion and swelling.  However, as the peak reaction time arises, you may initially notice less and less progress after your therapy sessions and exercise.  This does not mean that you have reached your best result.  As a matter of fact, this is a stage of continued remodeling of your hand, and it is important to continue your exercises at home and with your therapist.  You will notice improvements after therapy; however, you may find that when you wake up in the morning, your hand may be stiff.  You will notice an up and down kind of progress during this time, but within four to six weeks the strides that you achieve during therapy will be obtained and maintained indefinitely and you will not notice the ups and downs that you had during the plateau phase.

I want to emphasis that it is important during this plateau phase to continue your aggressive work on your own.  Your work is not for naught; you will notice your progress and success at the end, if you have done your exercises as outlined.

Revised 10/7/09 wh