Post-operative Instructions for Carpal/Cubital Tunnel Release
Wound Care
- You will have a sterile dressing which may be covered by an ace wrap or gauze. Please keep this clean and dry for 4 days. Until then you may take a sponge bath, or shower with a waterproof bag covering the arm (use rubber bands or tape at the top to prevent leaks).
- Remove the dressing after 4 days; if the incision is dry you may get the incision wet in the shower, but do not submerge in water.
- Some clear, yellowish, or bloody drainage from the incision is normal. If this happens, please keep the dressing in place until there is no further drainage. If the incisions are draining pus (opaque, thick, white fluid), or if there is redness that worsens over 1-2 days, call the office immediately. Do not apply any ointments or creams.
- If non-absorbable sutures are used, these will be removed at your follow up appointment.
Activity
You are weightbearing as tolerated on the operative arm; there are no restrictions on the use of your arm provided that you do not have pain. Let pain be your guide in terms of activity level.
Controlling your pain and inflammation
Some pain and swelling is normal after surgery. It is usually most severe for the first 2-3 days. The following strategies are especially important during this time. Try to anticipate an increase in pain when the anesthesia or nerve block wears off, usually within 12-24 hours.
- Ice – Apply an ice pack to your operative arm to reduce pain and inflammation. Take care not to put ice directly on the skin. You should continue this for the first 2-3 days or longer if you still have pain and swelling.
- Elevate – Put pillows under your operative arm so that it lies above your heart. This will help to drain fluid from the wrist and reduce swelling. Try to do this as much as possible for the first 3 days.
- Medication — You may have received a prescription for narcotic and / or anti-inflammatory medication. Please take them as instructed. The medication is most helpful if taken 30-45 minutes prior to any planned activity.
Follow up appointment
If an appointment has not already been scheduled, please call the office at 206-633-8100 and schedule an appointment for 10-12 days after your surgery. During this visit we will remove sutures, check your wound and assess your range of motion and function.
Returning to work
You may return to work when it is safe to do so within the above activity restrictions. Please note that your employer may prohibit narcotics while at work. Please continue to ice and elevate while at work. A doctor’s note or Duty Status form can be provided to you during your follow up appointment.
Driving
You may drive when it is comfortable to do so, and you are no longer taking narcotic pain medication. Please arrange for a ride to the clinic for your first post-operative appointment if still taking narcotic medication.
Medications and common side effects:
- Narcotics (oxycodone, hydrocodone, etc.) – prescription medication for reducing pain. They may cause drowsiness, confusion, nausea, and constipation. To avoid constipation, increase your intake of fiber, fruits, and vegetables, and stay hydrated. Over the counter laxatives can be taken to treat constipation while on narcotics; please see separate handout or ask your pharmacist.
- Anti-inflammatories (Ibuprofen, Naproxen, etc.) – available over-the-counter to reduce pain and inflammation.
Avoid them if you have diagnosed kidney disease or active ulcers. This medication can cause upset stomach; please take them with food. To treat an upset stomach, take an over-the-counter antacid or proton-pump inhibitor (ask your pharmacist for assistance). - Acetaminophen (Tylenol) – Used to reduce pain and decrease fever. Avoid taking this medication if you have liver disease. Taking more than the recommended dose can lead to liver damage. For an adult, it is safe to take up to 3-4,000 milligrams each day (24 hour period). Some prescription narcotics already have acetaminophen in them.
- Antihistamines (e.g., benadryl, hydroxyzine) – Used to treat some side effects from narcotic use, such as itching and nausea. Can cause drowsiness and confusion.
Please call the office if you have the following:
– Fever above 101°, pus draining from wound, worsening redness or rash
– Difficulty breathing
– Continuous bleeding from wound (see “wound care” above)
– Numbness or weakness that is not improving after the nerve block has worn off (1-2days)
– Intolerable pain when the above strategies for pain control have failed
For questions or concerns not addressed on this form, please call our office at 206-633-8100. The clinic is closed during the evenings, weekends, and holidays. For urgent matters after hours, an on-call provider can be reached at the above number.
