Dupuytren's Contracture Surgery

Care After

Surgery is done to straighten fingers of patients that have Dupuytren's contracture. Most people do not feel pain because of Dupuytren's contracture. The goal of surgery is to make the fingers move better. This includes being able to bend them and make them fully straighten again.

PROCEDURE

  • The surgeon made one or more cuts (incisions) in the palm of your hand.

  • Tissue below the skin that got thick was removed. This thick tissue is called fascia. This thickness is what started the problem. It pulls on the cords (tendons) that control the fingers. This caused them to curl in. The surgeon took out this thickened tissue. After the surgery the fingers should be able to fully straighten again.

  • The incisions were stitched closed. A bandage (dressing) was put over the incision. Your bandage may include a splint (a plaster or fiberglass piece) that will keep your fingers from moving.

  • Sometimes, some of the skin on the palm of the hand is removed. This happens when thickened tissue is attached to the skin. If so, a skin graft may have been done. A skin graft is a piece of skin taken from another part of the body. It becomes a patch for the skin that was removed. Sometimes the palm incision is left open by the surgeon to slowly heal over weeks to months- this is called the "open palm" technique.

AFTER THE PROCEDURE

  • You will stay in a recovery area until the anesthesia has worn off. Your blood pressure and pulse will be checked every so often. You may continue to get fluids through the IV for awhile.

  • Some pain is normal after this surgery. You will probably be given pain medicine while in the recovery area.

  • Most of the time, this surgery is an outpatient procedure. That means you will be able to go home the same day. Otherwise, you will be moved to a regular hospital room.

HOME CARE INSTRUCTIONS

  • Take whatever pain medication has been prescribed by the surgeon. Follow the directions carefully. Do not take over-the-counter painkillers unless the surgeon says it is OK.

  • Do not drive if you are taking prescription pain medicine.

  • Rest for the first day or two at home. After that, you can slowly return to most of your normal activities. Avoid things that involve the use of your hand.

  • Keep your hand raised (elevated). When you are resting, it should be above the level of your heart. Piling up several pillows should do this. Keep your arm held in the air or in a sling when standing or walking.

  • Check your fingers every 4 to 6 hours. They should look and feel like your other fingers. They should be the same color and temperature. Call your healthcare provider if they are not.

  • Let your healthcare provider know if your hand swells, or becomes painful or if your hand or fingers feel tingly or numb.

  • Do not get the dressing and splint wet. Take a sponge bath. Or, put a plastic bag over your hand. Tape it tightly around your arm. Then, shower. You will need to do this until your stitches are gone, or until the surgeon says it is OK to get your hand wet.

  • Be sure to keep all follow-up appointments.

  • You will probably need to go back to the surgeon to have the dressing changed. This is usually done about a week after the surgery. A new dressing may be put on.

  • You may need to come back again to have the stitches taken out. That usually happens 10 to 14 days after the surgery.

  • Occupational or hand therapy after surgery for Dupuytren's contracture is important. It usually includes stretching exercises for the hand. It also may include massage. This therapy may be done several times a week for a few months. It may take up to 8 weeks until you have full movement of your fingers again.

  • You may need to wear a splint at night for 3 - 6 months after your surgery.

SEEK MEDICAL CARE IF:

  • You have any questions about medicines that were prescribed or suggested.

  • Your hand hurts, even after taking pain medicine.

  • You have numbness or tingling in your hand or fingers.

  • The dressing gets wet.

  • You develop a fever of more than 100.5° F (38.1° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • Pain in your hand gets much worse.

  • Your fingers change color or become cold or numb.

  • You see any blood on or around your dressing.

  • The incision becomes red or swollen, bleeds or oozes pus.

  • You develop a fever of more than 102.0° F (38.9° C).