Patient Post-Operative Instructions Page Gary B. Schwartz, MD www.orthodoc.aaos.org/gbschwartz
Broward Institute of Orthopaedic Specialties, LLC
Your post-operative recovery period is an essential part of the entire process of surgery and a return to optimum function. Your recovery is very important to me and I know it is important to you. I have discussed your recovery period with you at the time we decided that surgery was the best option for you, but I want to give you some written guidelines and instructions to have. I think that these will help you through your recovery period.
Pain Medication
You may be given a prescription medication for pain. Sometimes various side effects can occur. These may include , but are not limited to: constipation, diarrhea, nausea, indigestion, drowsiness, or addiction.
Use the prescription strength medication only if needed. Do not take them just because I gave it to you.
Many times, over the counter medication can help also. If you are taking an anti-inflammatory medication, please take them with food. If you vomit black material or are having black stools, discontinue the medication and call my office.
Keep Your Hand Elevated
Surgery usually results in swelling. Most of the pain and stiffness right after surgery is due to internal pressure from swelling. To relieve the pressure, raise your hand higher than your heart to drain fluid out of your hand. Keep your hand up as much as possible, day and night. This is more effective in relieving pain than any medication. Swelling will decrease your ability to move your fingers later on. If putting it in a sling is not sufficient to help the pain, you can try to put your arm up in the “Statue of Liberty” position.
Swelling may also make the cast or bandage tight, which will cause more pain and swelling. When you go to sleep, the best way to keep your arm elevated it to put 2 or pillows on your chest, and then put your arm on the pillows. I you feel that your cast, splint, or bandage is too tight, please contact me. I would rather change it than for you to have a problem.
Keep Your Bandage Dry
Wounds heal with the fewest problems if they are kept clean and dry. When bathing, protect your bandage in a plastic bag. If your bandage gets wet on the inside, it should be changed, not simply allowed to dry. I would rather change your cast, splint, or bandage than risk a problem with your wound. Once wounds are dry, they only need bandaging to protect stitches from catching on sheets or clothing.
Moisturizing
Your skin will become dry and may peel after surgery. This is not unusual. After stitches are taken out, you can apply vitaman E oil with aloe vera or cocoa butter. I will let you know when you can begin to do this.
Bruising or Bleeding
You may have some black and blue discoloration around the area of the incision. This is very common. It can travel down your arm over the next few days (from gravity and elevating your arm) This is normal and comes from blood seeping through the tissues. It is not usually a source for concern unless accompanied by steady drainage, worsening pain, or progressive swelling .If you have any concerns, please call me.
Bandage Changes
Once the initial bandage is removed, dressings can be changed as often as needed to keep wound drainage from soaking the gauze. Soiled dressings should be changed. Change your dressing only if I have given you specific instructions to do so before I see you.

Infection
This should be suspected if there is redness, pain, or swelling that gets worse over the course of the day or night, despite elevating the hand. Infection is uncommon less than four days after surgery. A low grade fever is not unusual after surgery. If you think that you have a fever, take your temperature with a thermometer. White patches of skin are usually areas that are too moist. This can lead to infection. This may be due to a bandage which does not breathe enough. If this occurs, make the dressing smaller. Red patches of skin may be where the bandage has been rubbing or is too tight. If these areas itch, you may have an allergy to the dressing.. Adhesive tape can be irritating. Please put tape directly on the bandage and not on the skin. . Call me if your have any concerns regarding the development of an infection.
Sunlight
Burns can be a problem with recently healed skin. Your skin incisions can be easily burned by the sun.
Please avoid sun exposure or use sun block on the scars for at least six months.
Smoking
This interferes with healing and makes painful problems more painful. Problems after surgery are more likely if you smoke, especially if you keep smoking after surgery. DON’T SMOKE.
Pins Left Protruding Through The Skin
These must be kept clean and protected from catching on sheets or clothing. The pins may be removed in the office, but in certain situations I will need to arrange for removal in the operating room. If the pins get wet from washing, clean the pin and the point where the pin enters the skin with hydrogen peroxide and a
Q-tip. Drainage is normal if it is clear or yellow/orange from the pin sites. Pins may become loose or turn in place. This is usually not a problem. A pin can catch on material and pull out partially. This is usually not a problem. If you have any concerns regarding your pins, please call me.
Cast Care
Your cast may be water-resistant. The padding under the cast is not water repellent. Therefore, you must keep your cast as dry as possible to prevent skin irritation and odor. The inside of the cast should be dried with a hair drier (cool setting) until it is completely dry. When bathing , cover the cast with a plastic bag.
Position your hand so that water does not run down inside the cast.
Do not trim your cast. The cast or splint has been designed to provide maximum support during healing. If it is altered, it may increase your recovery time. If the cast rubs against your skin, you can put moleskin or other padding on the edges. If the cast or splint feels too tight or is irritating your skin, please call me. I may have to modify or change the cast. I would rather do this than for you to have a problem.
It is very common for cast or splints to itch. Please do not inset anything under your cast to scratch an itch. This can cause a skin injury. Do not put powder or corn starch inside the cast. This can cause an infection to occur.
If the following occur, please contact me:
-if your cast rubs or presses against your skin.
-if your cast becomes uncomfortably snug or tight.
-if your fingers become swollen, numb or tingly, difficult to move, or become cool or discolored.
-moderate discomfort develops into severe or constant pain, unrelieved by elevation of the affected part.
Follow-Up Appointments
You should always have a follow-up appointment after surgery. You will receive a discharge instruction sheet before you leave the surgical facility. The day and office which I would like to see you for your follow-up appointment will be documented on that sheet. Please call my office (954-966-6450) on the day of discharge to set up the appointment.
I have tried to cover the usual questions that patients have asked me over the years. I cannot cover all questions and all situations. Use your judgment: if you need to call me, try to do so during office hours, but
I or a covering physician are always available to help you or discuss your recovery with you. Your recovery is important to both of us.
Gary B. Schwartz, MD www.orthodoc.aaos.org/gbschwartz