Endoscopic Carpal Tunnel Release
The carpal tunnel space is a narrow passageway in the wrist, about an inch wide. The floor and sides are formed by the small wrist bones. The roof of the tunnel is a ligament. The carpal tunnel protects the median nerve and flexor tendons that bend the fingers and thumb. Numbness and tingling are caused by pressure against the median nerve. During the carpal tunnel release, the transverse carpal ligament is cut to provide more room for the nerve and tendons.
- Keep the post-operative bandages clean and dry.
- You may remove your surgical dressing the night of surgery and wash your hand as long as there is no active bleeding. You may wash your hand, but do not let the hand soak in water. It is not unusual to have some mild bleeding/oozing from the wound at this time. You may cover the wound with limited dressings/Band-Aid as needed.
- You may shower with the wound uncovered after 24 hours.
- DO NOT SUBMERGE the wound. No bathtubs, hot tubs, pools, and/or dish water. This type of environment is often unsanitary and can lead to possible infection.
- **Therapy is usually not needed after surgery, but if scaring affects functional use of the hand a few visits may be beneficial to reduce the deep scar tissue**
- You may use Tylenol (acetaminophen). DO NOT EXCEED 3000 mg of Tylenol in 24 hours.
- You may also alternate ibuprofen with Tylenol to supplement pain control.
- It is recommended to use narcotics ONLY as needed (and directed) for additional pain control. Take it with food to prevent nausea. Extended use of narcotics can lead to dependency/addiction and cause severe constipation and GI complications.
- Please keep the area elevated as much as possible for at least the first 5 days or until the swelling improves. You are using gravity to help assist fluid movement out of the area.
- Please refrain from full-body exercises or activities that increased blood pressure and heart rate to prevent increased bleeding from the wound.
- You are encouraged to move the joints of your wrist and fingers a few times an hour. Moving the joints helps assist in fluid movement of the surgical area preventing joint stiffness, pain and loss of function.
- It is important to move your hand, wrist and fingers. Stiffness and soreness is normal and will decrease with time and activity.
- Returning to work and work-related activity will depend on your occupation and work environment.
- NO DRIVING while under the influence of narcotic pain medication.
- NO SMOKING. Smoking interferes with circulation and wound healing and may cause serious complications such as wound infections. It is in your best interest to refrain from smoking.
First Post-op Visit:
- Often 8-10 days post-op unless directed otherwise. This visit is scheduled during the scheduling of your surgery.
- Sutures are removed between 8-14 days depending on the extent of the wound and your past medical history. Uncontrolled blood sugar (diabetes), smoking, certain medically conditions and some medications can delay healing.
- Sutures are left in longer in situations of possible delayed healing and you may be directed to return at a later date for suture removal.
- Scar Tissue Massage
- Post-operative wounds/incisions heal with scar tissue. The network of fibers that make up scar tissue changes and improves over time. Massaging a healing wound causes the fibers to align themselves to the directional stress you apply making the skin more pliable like normal skin. This action also desensitizes the wound. The best way to see it is to “move the tissue around and over the scar in all directions like kneading dough.”
- You may use Aloe-Vera/Vitamin E skin cream
- Formal therapy is often not needed. Occupational therapy may be initiated in certain situations. You will be encouraged to continue a home exercise program and activity modifications.
- Time-frame for post-operative recovery
- Everyone recovers from surgery at their own pace. You can anticipate a return to activities “as tolerated” without restrictions 4-6 weeks following surgery.
- Returning to activities as tolerated without restrictions does not mean there is an expectation you will be pain/symptom free. The hand will need time to develop muscular endurance as you expose it to increasing activity much the same way an athlete develops endurance to run 10 miles.
- Your post-operative pain, swelling, range of motion and overall function will depend on how proactive/compliant you are with your post-operative care, activity modifications/restrictions and home exercise program.
When to Call?
Please call the office if you have any questions or concerns regarding your post-operative care. If any of these symptoms are present please call:
- Persistent fever greater than 101.5 °F or 38.5 °C
- Increasing pain or swelling not controlled with medications
- Excessive drainage or bleeding on the bandage
- Chest pain, difficulty breathing, nausea, vomiting
- Cold fingers, or painful fingers that are not normal in color
- Increasing redness beginning 7 days after surgery