Patient Care Info | Hand Microsurgery & Reconstructive Orthopaedics

Hand Microsurgery office provides a 24 hours a day, 7 days a week answering service to address your questions.

Cast Care

• When dealing with a cast, be sure to elevate your injured extremity above your heart for the first few days after the cast has been applied.This prevents swelling by allowing the body fluids to drain. Ice should be applied directly over the fracture or injury for the first 48 hours. This also helps to reduce swelling and pain. You should also be sure to always observe for coldness, numbness, tingling, tightness, swelling, or blue discoloration of the extremity involved. If you are elevating your extremity and notice these symptoms, contact the medical staff of Hand Microsurgery at once.

• Exercise is very important in order to keep your muscular strength. Be sure to remember to continually make a fist and straighten your fingers or toes, which will improve circulation thereby helping to reduce swelling and promote healing.
• Do not put anything down your cast for any reason, such as hangers or any instrument that may poke the skin. This could cause irritation or infection. Parents should be especially careful with small children who may put coins or other small objects inside their cast. Follow-up care is important and extremely necessary.
• Keep your cast dry at all times and use a plastic bag over your cast while showering or bathing. The fiberglass material of the cast is water resistant but the padding underneath is not. This will cause skin breakdown if it becomes damp. Call our office immediately if your cast becomes wet and cannot be dried with the use of a hair dryer. Pain medication may have been ordered. Take as directed and do remember, if your pain should become severe and somewhat relieved by medication, call our office at any time.
• The use of slings should be limited unless otherwise ordered by your physician. Keeping your arm in a sling may cause further discomfort/stiffness or problems from limited movement. If you are wearing a sling, be sure to get instructions from your doctor.
• Your cast will be removed by a specially designed cast saw. This saw has a vibrating blade that moves back and forth and does not spin around. It makes a loud noise and you will feel vibration and pressure, but you should not experience discomfort. It is good to prepare small children for this procedure so that they will not be frightened.

Wound Care

The following steps should be done twice a day:

1. Remove old dressing – some of this may stick and can be removed when soaking.
2. Lay hand or finger in bowl or cup and pour straight peroxide over wound until area becomes completely submerged. Your wound should remain in peroxide for about 10 minutes. Foaming in the presence of old blood or debris is normal.
3. Once the wound has soaked, remove from peroxide and dry. Air drying is good for short time intervals after each soak.
4. Cover your wound with Xeroform (yellow sterile dressing) if prescribed, followed by dry sterile 2×2 or 4×4 and Kling. For finger injuries, Coban will be applied over 2X2 dressing followed by splint if necessary, and more Coban. In larger wounds, once the wound is covered apply splint and secure with Ace bandage.

Note that some drainage is to be expected but if you notice large amounts of yellow-green drainage or notice an increase in redness with more swelling, please call the Hand Microsurgery office immediately.