What happens on the day of my Carpal tunnel surgery?
Carpal tunnel release is a very common procedure with a high success rate at relieving the nerve symptoms. Surgery is performed under local anaesthesia with the patient being fully awake. Your surgeon will explain once again the risks and benefits of the surgery as part of the pre-operative consent process, then you will be given a chance to ask any questions.
Once you are changed into theatre clothing, the surgical site is numbed with medications that help to keep the wound pain free and bloodless during the surgery. At the end of the procedure, the wound is closed with absorbable sutures which should dissolve in two to three weeks. The whole procedure should take no longer than thirty to forty-five minutes. Although it is a local anaesthetic procedure and most patients travel back home without assistance, we recommend you bring a family member or friend with you to accompany you home.
Can I use my hand straight after surgery?
As long as the wound is not very painful, there shouldn’t be any issues using the hand to carry out simple activities such as; holding a knife and fork, using electronic devices and reaching out for things as needed.
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 three to five days following surgery. Avoid placing the hand and wrist in a sling. The local anaesthesia used during surgery will begin to wear off around six to eight hours after surgery. It's a good idea to have some over the counter medications such as paracetamol and anti-inflammatories at hand should you need them.
Exercise is key to recovery. Make a complete fist, making sure that the tips of the fingers curl right into the palm, then straighten the fingers. This exercise should be performed for three to five minutes every two to three days as early as the same day of the surgery and should be continued for the first two weeks following surgery.
What level of wound care do I need?
It is uncommon for patients to routinely see a 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 ten to fourteen days. You can change 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 you massage 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 a high density of very small nerve fibres, occasionally there may be prolonged scar sensitivity beyond six to eight days after surgery. In such instances you may be referred to a hand therapist who will 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 you develop scar sensitivity, stiffness of the hand and swelling of the fingers, you will be referred to the hand therapists at the six to eight-week review post-surgery.
When can I go back to driving and start working?
Once the wound is healed, relatively pain free and dry, you can start driving. It is however recommended that you take the car to an open space and check whether you have full control of the car prior to commencement of driving on a public road.