What happens on the day of my Carpal tunnel surgery?
Carpal tunnel release is a very common procedure with a high success rate relieving the nerve symptoms. This surgery is performed under local anaesthesia with the patient being fully awake. The surgeon explains once again the risks and benefits of the surgery as part of the pre-surgical consent process and you would be given a chance to ask further questions regarding your condition. Once you are changed into the theatre clothing, the surgeon numbs the area of surgery with injectable medicines that help to keep the surgical wound pain free and bloodless during the surgery. Once the procedure is completed, the wound is closed with absorbable stitches which should dissolve in two to three weeks. The whole procedure should take no longer than 30 to 45 minutes. Although it is as local anaesthetic procedure and most patients travel back home without assistance we recommend you bring a family member or friend with you to accompany home.
Can I use my hand straight after surgery?
It is recommended that you keep your hand elevated so that it is above the level of your heart for most part of the day for the first 3 to 5 days following the surgery, for the same reason avoid placing the hand and wrist in a sling. The local anaesthesia used during surgery would begin to wear off around 6 to 8 hours of surgery and we recommend you have some over the counter medications such as paracetamol and anti-inflammatories at hand should you need them. One can start making a complete fist making sure the tips of the fingers curl right into the palm, and be able to straighten the fingers fully. This exercise should be performed 3 to 5 minutes every two to three as early as the same day of the surgery and should be continued for the first 2 weeks following surgery. As long as the wound is not very painful, we do not foresee any issues using the hand to carry out simple activities such as holding a knife and fork, using electronic devices and to reaching out things as needed.
What level of wound care do I need?
It is uncommon for patients to routinely see specialist nurse for wound related issues after carpal surgery as wound complications are rare. It is recommended that the wound is kept dry until it is completely healed which takes usually 10 to 14 days. One can take down the dressings over the wound at home under sterile conditions. The suture material that is visible over the wound will dissolve eventually. It is strongly recommended that patient massages the scar three to four times a day with over the counter non-perfumed creams to prevent scar sensitivity. As the palm of the hand has high density of very small nerve fibres, occasionally patients can have prolonged scar sensitivity in the vicinity of the wound beyond 6 to 8 after surgery. In such instances patient will benefit from a referral to the hand therapist who would work on specialist scar desensitization techniques.
Do I need hand therapy (specialist physiotherapy to the hand and wrist) after surgery?
The majority of patients do not need hand therapy following carpal tunnel surgery. However, should the patient develop scar sensitivity, stiffness of the hand and swelling of the fingers, the patient will be referred to the hand therapists at the 6 to 8-week review.
When can I go back to driving and start working?
Once the wound is healed, relatively pain free and dry one can start driving. It is however recommended that one takes the car to an open space and check whether he/she has full control of the car prior to commencement of the driving on public roads.