Dupuytren's Release (palmar fasciectomy)

What to Expect

You should expect to feel a bit of pain for the first two days.  After this, your pain should significantly improve.  You will have limited use of the hand for two weeks.  After this, the hand will become more useful but will not return to normal for about two months.  The scar will take 12 months to finally settle.

Surgical Site Care

Your bandage should stay on and dry until your first follow-up visit with either the doctor’s office or hand therapy.  You may have to protect it when bathing with a plastic cover bag.  
After your first visit, you may wash the incision with soap and water.  Peroxide diluted in half with tap water can be used on a Q-tip to dab the incision and break up clots if necessary.  When the incision is dry, you can then redress it with antibiotic ointment or Vaseline and cover with a bandage.  Do this as often as needed over the course of the day.
If you have a splint, this should be worn as much as possible for the first three weeks.  After this, the splint should be worn at night for another three weeks. 
When the incision is closed and your stitches are removed, you can start to massage your scar.

Activity and Care at Home

You should maintain a gentle level of activity until instructed by your doctor.  Most patients should be able to return to more vigorous activity when the incision is healed at two weeks.  You should limit lifting with the surgical hand to less than three pounds until six weeks. The hand should be elevated as much as possible to minimize swelling.
You should keep the fingers moving several times a day to prevent them from getting stiff.

Medications and Pain Management

You will have freezing in your hand that helps with your pain control.  The freezing may last for 1-8 hours.  When the freezing wears off, you may feel tingling in your fingers.  This is a good time to start taking your oral pain medication.  You can refer to the pain management handout. 
You should keep your hand elevated about the level of your heart.  Slings are not needed.

What to watch for / when to call / who to call

Call your doctor’s office, see your GP, or visit the emergency room if you feel acutely unwell, have excessive bleeding, foul smell, you notice redness extending up the hand or arm or if you have a significant fever or significant and increasing pain.

Follow-up

Your doctor’s office should have given you the dates and times of your follow-up visit in the information you received with your surgical information.  If you do not know your dates, please contact your surgeon’s office.
If you have a referral to hand therapy (not all patients require this), contact the hand therapists as soon as possible to arrange an appointment. A prescription for hand therapy if needed will be provided at the time of surgery.