Carpal tunnel wound advice? not for the squeamish

[eldudereno]

Had a carpal tunnel release op done last Friday but am a little concerned about the wound because of the tissue that's protruding from it. Am I correct in thinking that this is fatty tissue that will lose its blood supply, shrivel up and come away from the wound? I removed the big thick dressing the next day as advised by the surgeon and this is what I found so I presume that it must have been stitched up that way. Thanks for any advice.

[King Herald]

eldudereno said:

Had a carpal tunnel release op done last Friday but am a little concerned about the wound because of the tissue that's protruding from it. Am I correct in thinking that this is fatty tissue that will lose its blood supply, shrivel up and come away from the wound? I removed the big thick dressing the next day as advised by the surgeon and this is what I found so I presume that it must have been stitched up that way. Thanks for any advice.

That does look like fat poking out, not that I'm an expert. I'd go back, show them, and ask what the score is. Looks like clumsy stitching really.

This pic is mine, two days after the op. Now, two years later, I can't even find the scar!

I was told to exercise it as much and as soon as I could, so I did, and I was back out in the workshop within a couple of days of the op, doing light work. After a week I was holding an angle grinder with it, though I kept a work glove on it for several weeks after the op.

The stretching and flexing exercises the physio showed me have improved my other (uncut) hand as well, and if I'd known about them before I'd probably have not got the first hand done!

I had mine done private, about £3000, but a friend had his done on the NHS, and he was told to rest his totally for a week, not to use it at all, and it is now worse than before the op!?

If you DON'T exercise is the scar tissue will adhere to the tendons, and the carpal strap will simple rejoin, possibly tighter than before.

Edited by King Herald on Sunday 4th October 20:15

[eldudereno]

Thanks for the excellent reply. I was lucky enough to get it done privately through my company medical insurance but my stitches look completely bodged compared to yours. I wasn't given any instructions at all on how to look after my hand and physiotherapy has never been mentioned. I did receive an out-patient appointment yesterday for the end of next month but that's almost 2 months after the op which is totally crap.

Cheers for the heads up on the flexing/stretching exercises which is news to me. I'm a bit like yourself so want to start working on my car and finishing my brothers bathroom off asap.

Will probably get down to my local hospital tomorrow to get the stitches sorted out.

Thanks again.

[King Herald]

eldudereno said:

Thanks for the excellent reply. I was lucky enough to get it done privately through my company medical insurance but my stitches look completely bodged compared to yours. I wasn't given any instructions at all on how to look after my hand and physiotherapy has never been mentioned. I did receive an out-patient appointment yesterday for the end of next month but that's almost 2 months after the op which is totally crap.

Cheers for the heads up on the flexing/stretching exercises which is news to me. I'm a bit like yourself so want to start working on my car and finishing my brothers bathroom off asap.

Will probably get down to my local hospital tomorrow to get the stitches sorted out.

Thanks again.

You need to go back to see the surgeon you paid to do the job, as it is his responsibility if anything goes wrong. And if you do have problems later he might reject your complaints because someone else re-did the stitches. Also ask him about flexing. There may be differing techniques for the release operation, but if you think about it all the internal stuff he cut simply wants to re-join together, so it should make sense to keep it working around.


These are the exercises I was given, and told to start ASAP. The rather cute looking nurse also said that I would know if I was overdoing it as my hand would soon let me know: Pain.

Right, start flexing by way of curling a fist with your thumb inside, like they always tell you not to make a fist at school. Then curl it inwards towards your inner arm as far as you comfortably can, hold for ten seconds, then flex back out as far as you can, hold for ten seconds. Do that about five times in a row, three or four times a day.

Open your hand wide, fingers as wide as you can, hold it back as far as you can, hold for ten, then curl a thumb-inside fist, hold tight for ten seconds.

Twirl your hand around stretching all ways for ten times in each direction. Again do these four or five times a day.

I still do these, with both hands, whenever I think about it as it keeps your hand/tendons/carpal strap loosened up.

[eldudereno]

Great stuff, thanks again!!!

Will start the exercises straight away.

I'll give the hospital in question a ring and see what they say, it'd bl**dy annoying though as this bodge is just delaying my recovery.

[The_Doc]

go back and see your surgeon ASAP.

That fat will shrivel and die, but you don't want infection at that spot.

Movement must be early and gentle to keep the tendons gliding.

The skin should be a complete physical barrier once sutured, yours is not.

Sorry, but I've done hundreds of carpal tunnels, and none like yours.

[King Herald]

The_Doc said:

go back and see your surgeon ASAP.

That fat will shrivel and die, but you don't want infection at that spot.

Movement must be early and gentle to keep the tendons gliding.

The skin should be a complete physical barrier once sutured, yours is not.

Sorry, but I've done hundreds of carpal tunnels, and none like yours.

Getting mine done was a major decision, as the idea of it going wrong was a big worry, which is why I got my left hand done first.




Does it ever go wrong?

ETA: I guess I answered question that in my first post, as my buddy never exercised his hand for the first week, and now it is worse than before.

Edited by King Herald on Monday 5th October 13:40

[southendpier]

King Herald said:

The_Doc said:

go back and see your surgeon ASAP.

That fat will shrivel and die, but you don't want infection at that spot.

Movement must be early and gentle to keep the tendons gliding.

The skin should be a complete physical barrier once sutured, yours is not.

Sorry, but I've done hundreds of carpal tunnels, and none like yours.

Getting mine done was a major decision, as the idea of it going wrong was a big worry, which is why I got my left hand done first.




Does it ever go wrong?

My old man got his wound severly infected, a few days after coming out of hospital, thought it would sort itself out - it didn't, he then had to spend the over a week in hospital recovering from fever and sever infection, bloating of his lower arm and fingers. Had the wound drained, infected bits of finger cut away, only then could the hand then repaired with new skin grafts.

so the advice is get it looked at!

[King Herald]

southendpier said:

King Herald said:

The_Doc said:

go back and see your surgeon ASAP.

That fat will shrivel and die, but you don't want infection at that spot.

Movement must be early and gentle to keep the tendons gliding.

The skin should be a complete physical barrier once sutured, yours is not.

Sorry, but I've done hundreds of carpal tunnels, and none like yours.

Getting mine done was a major decision, as the idea of it going wrong was a big worry, which is why I got my left hand done first.




Does it ever go wrong?

My old man got his wound severly infected, a few days after coming out of hospital, thought it would sort itself out - it didn't, he then had to spend the over a week in hospital recovering from fever and sever infection, bloating of his lower arm and fingers. Had the wound drained, infected bits of finger cut away, only then could the hand then repaired with new skin grafts.

so the advice is get it looked at!

Bad news.

I kept mine as sterile as I could, a large plaster on it, rubber surgeons glove over it, and a work glove over that, when I was in the garage.

It did heal really quickly, which is something the OP's hand doesn't look like it will.

I was also advised to gently massage the cut itself, to stop a large clump of scar tissue forming.

[eldudereno]

The_Doc said:

go back and see your surgeon ASAP.

That fat will shrivel and die, but you don't want infection at that spot.

Movement must be early and gentle to keep the tendons gliding.

The skin should be a complete physical barrier once sutured, yours is not.

Sorry, but I've done hundreds of carpal tunnels, and none like yours.

Thanks for the replies everyone.

Just got back from the hospital, they trimmed the protruding tissue, gave it a clean and bandaged me up again. The doctor that inspected it did say that the surgeon could have put more stitches in the wound.

The_Doc...thanks very much for your input, the people at the hospital were really nice and friendly but I'll be looking elsewhere to get my left hand done. If there had been too much excess tissue, surely the surgeon could have trimmed this back a little before closing up?

[The_Doc]

eldudereno said:

Just got back from the hospital, they trimmed the protruding tissue, gave it a clean and bandaged me up again. The doctor that inspected it did say that the surgeon could have put more stitches in the wound.

Could have.....

the tissue swells post-op and a full row of sutures could have prevented the fat from bulging through.

I'm sure you will be fine, best wishes.

[mybrainhurts]

Ohhh....

[drfrank]

Was it an Orthopaedic job or General Surgery job, personally anything delicate (median nerve) I would only let a plastic surgeon at !

[eldudereno]

An Orthopaedic surgeon carried out the op, makes me wonder if he was actually wearing a blindfold.

I noticed that it was bleeding a few mins ago so decided to give it a clean and apply a new dressing, so this is how it looks this evening. Looks like I'll have to visit them again tomorrow to get some more sutures.

Edited by eldudereno on Tuesday 6th October 19:40

Edited by eldudereno on Tuesday 6th October 19:41

[captainzep]

How man and the ser-called 'doctaz' on this thread. It was me what operated on the Errr-Pee's corpal-toonel reet?

What yeez all got tee remembor, reet, is that the Health Sorvice in Tayne 'en Weah is different to what yeez used te.

Its hard te concentreate on yer suturin' when there's a sexy fat norse stood next te yez (who carrn't herld the torch propah eurvah the wound), reet? And yerve got Terny behind the borr callin' "last ordahs", and yer carn't steady yer fookin' hahnds because of the smerkin' ban?

Give us a fookin' break will yez? Ah washed me hahnds an' that. Yez should see me hips. Carnage man.

ETA -just seen the pherterh aboov. What's the fookin' problem now? Get some Germerleen on it ya queeah, an' gan to the boozah.

Edited by captainzep on Tuesday 6th October 23:28

[eldudereno]

Think you need to make an appointment to see a psychiatrist tomorrow.

[triggersbroom]

captainzep said:

How man and the ser-called 'doctaz' on this thread. It was me what operated on the Errr-Pee's corpal-toonel reet?

What yeez all got tee remembor, reet, is that the Health Sorvice in Tayne 'en Weah is different to what yeez used te.

Its hard te concentreate on yer suturin' when there's a sexy fat norse stood next te yez (who carrn't herld the torch propah eurvah the wound), reet? And yerve got Terny behind the borr callin' "last ordahs", and yer carn't steady yer fookin' hahnds because of the smerkin' ban?

Give us a fookin' break will yez? Ah washed me hahnds an' that. Yez should see me hips. Carnage man.

ETA -just seen the pherterh aboov. What's the fookin' problem now? Get some Germerleen on it ya queeah, an' gan to the boozah.

Edited by captainzep on Tuesday 6th October 23:28

Actually, that must have taken a while to type - no?

Edited by triggersbroom on Tuesday 6th October 23:41

[captainzep]

eldudereno said:

Think you need to make an appointment to see a psychiatrist tomorrow.

Cheeahs for thah concern but mental illness doesn't acktchly exist in Tayne 'en Weah. Just something we health prerfeshenels call 'the hordness spectrum' rayngen from 'queeah' -te 'propah hord'.

Ser ner need for head doctaz heeah.

[eldudereno]

The consultant that carried out my op could well be in need of a head doctor, not of the psychiatric kind, tomorrow when I pay them a visit. The incision still hasn't healed with one side about 4mm higher than the other. Three of the 5 sutchers have also come loose and fallen out. I asked a first aider to remove the 2 other sutchers and hold the incision together with skin closures but in my personal opinion the incision needs tidying up with a scalpel. I've got no medical background but it's clear to me that the incision needs opening up sufficiently in order to create a good blood supply to either side in order for it to knit together and heal correctly.

[King Herald]

eldudereno said:

The consultant that carried out my op could well be in need of a head doctor, not of the psychiatric kind, tomorrow when I pay them a visit. The incision still hasn't healed with one side about 4mm higher than the other. Three of the 5 sutchers have also come loose and fallen out. I asked a first aider to remove the 2 other sutchers and hold the incision together with skin closures but in my personal opinion the incision needs tidying up with a scalpel. I've got no medical background but it's clear to me that the incision needs opening up sufficiently in order to create a good blood supply to either side in order for it to knit together and heal correctly.

Get back and insist he see you immediately. Demand he do something proper to fix it, rather than just a quick re-stitch or a bandage.

This is your hand he is messing about with, your livelihood. That's one reason I only had my left done first, too nervous to commit to somebody sawing away at both at the same time.