Swelling and pain therapy
All hands swell after injury or surgery. Swelling is an accumulation of
extra body fluid, and causes many problems even if it is not visible. Most
of the pain and stiffness which follows injury or surgery is due to
pressure in the wound from swelling. The best treatment is to reduce this
pressure by elevating the the hand higher than the heart (which lies behind
the breastbone). For several days after surgery, the hand soaks up extra
fluid like a sponge. During this time, every minute that the the hand is
not elevated, it swells. However, every minute that the hand is kept
elevated, veins siphon this fluid out of the hand and back to the heart.
For at least three days after surgery every effort should be made to keep
the hand elevated higher than the heart - day and night. Swelling may also
be aggravated by tight splint straps or bandages such as an ace wrap, and
these should be placed loosely on the forearm.
Smoking interferes with wound healing, and increases the chances that skin
and bone will not heal properly. It also tends to make wounds more painful,
and blocks the action of some pain medications. Smoking may directly
aggravate many hand problems, and should be avoided.
Infection 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 or more than two
weeks after surgery. The physician should be notified if there is any
question of infection.
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