Hand Elevation after surgery - A Recent Publication
A Recent Study looking into Postoperative Hand Elevation and the effect it has on the Reduction of Swelling
Authors from Cheltenham, in a study, investigated the effect hand elevation had on the reduction of swelling postoperatively.
113 patients underwent one of two routine procedures that the authors regularly perform at Cheltenham General Hospital. The two procedures were; a fasciectomy for Dupuytren's disease or a trapeziectomy. These are also two procedures that Mr Mike Hayton regularly performs on some of his patients.
The patients were randomly split into Group 1 and Group 2. Group 1 had 63 patients and was the group whose hands were elevated postoperatively. Group 2 had 50 patients and had no form of hand or limb elevation post operatively. Patients in Group 2 were allowed to rest their hand in a position which felt most comfortable to them.
Patients' hand swelling was measured using a water displacement technique. Patients' had to place their hand into a graduated chamber up to a marked depth. The chamber contained sterile water to prevent any possible infection being contacted and the sterile water was fixed at a set temperature of 24 degrees centigrade.
Once the patient's hand entered the chamber, the volume of water displaced was then calculated. Measurements for each participant were taken 30minutes prior to surgery and again 24 hours later.
However, 12 patients were unable to participate postoperatively due to their excessive hand dressings and secondary pain. So overall, the authors of this study looked at 101 patients when assessing the effects of hand elevation on the reduction of swelling.
Results from this study suggested no participants suffered any complications following a lack of postoperative elevation of the hand.
Although there was a very small increase in volume of water displaced in Group 1 over Group 2, there was no statistically significant difference between them.
Concluding from this, authors from this study found no significant evidence that hand elevation for 24 hours postoperative reduced swelling. However there were no complications from doing so either, so many surgeons continue to practice hand elevation postoperatively on these two regularly performed procedures.
Mr Mike Hayton now applies hand elevation for more major operative procedures which predictably incur a higher expectation of swelling.
The Journal of Hand Surgery (European Volume. 2010) 35E: 3: 192-194
R.P. Baker, J. Field, C. Gozzard, M.C. Wyatt and Y. Roberston
From the Cheltenham General Hospital, Cheltenham, UK