Preparing for hand surgery: a patient checklist

Hand surgery is unusual among operations in that the recovery interferes with almost everything you do, including the things you would normally do to look after yourself. Preparation starts at home, not on the day.

Confirm the details

Check the date, time and place, and whether you are going home the same day. Confirm which procedure is planned, in the words your surgeon uses.

Provide a complete list of medications, vitamins and supplements, and declare every health condition and allergy. Clarify what anaesthesia is planned — local, regional or general — and the fasting instructions that follow from it. Ask what the pain relief plan is afterwards and whether hand therapy is part of the plan.

Write your questions down before the pre-operative appointment.

Medication

Some medication is stopped or adjusted beforehand: blood thinners including aspirin and warfarin, anti-inflammatory drugs, fish oil and some herbal supplements, and certain diabetes medications.

Do not stop anything on your own initiative. Ask, and be told.

Preparing yourself

Shower with antibacterial soap the night before or the morning of surgery, and apply nothing afterwards — no lotion, deodorant, powder or perfume. Remove jewellery, nail varnish, make-up and contact lenses. Keep nails short and clean.

Wear loose clothing with wide sleeves or buttons; you will not be putting an arm through a narrow sleeve afterwards.

Observe the fasting cut-off exactly. Stop smoking at least two weeks before, and follow any instruction about alcohol.

Setting up home

Assume you will have one usable hand, and that if the operation is on your dominant side it will be the wrong one.

Clear and tidy the rooms you will use. Move what you need daily to within easy reach. Prepare meals in advance or stock things that need no preparation. Arrange help with the household tasks that need two hands.

Set up a place to rest where the hand can be elevated, because elevation does more for swelling than anything else. Voice controls and one-handed tools are worth setting up before rather than after.

Transport and support

You cannot drive yourself home. Arrange someone to take you, and someone to stay for the first twenty-four hours if you have been advised to.

That person may need to help with medication, meals and dressing changes. Arrange it early — discharge is often earlier in the day than people expect.

What to bring

Identification and any insurance details, a copy of your medication list, comfortable clothing, warm socks and slip-on shoes, and any consent forms or medical documents you have been asked for. A charger or something to read. Keep the bag light, because you will be carrying it one-handed on the way out.

Recovery and rehabilitation

Attend the hand therapy or occupational therapy appointments — in hand surgery these are not an optional extra, and the result depends on them as much as on the operation.

Keep the hand elevated. Watch for warmth, redness or discharge and report them. Avoid loading the hand until you are cleared. Ask when strengthening exercises begin and what they will be.

People

Tell the people around you what you will need: lifts, someone checking in, household tasks covered, work adjusted. A period of one-handed living is frustrating in a way that is easy to underestimate, and arranging support in advance is part of the preparation rather than an admission of anything.

Ask before the day

What are the risks and the benefits of this specific procedure; what anaesthetic will be used; what is the expected recovery timeline; will I need therapy and when does it start; what should I stop taking; and what movements must I avoid afterwards.