Fasciectomy for Dupuytren's Contracture: Before Your Surgery

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What is a fasciectomy?

Normal hand structures and a hand with Dupuytren's contracture

Fasciectomy (say "fash-ee-EK-tuh-mee") is surgery to cut out a layer of tissue called the fascia (say "FASH-ee-uh") that lies deep under the skin. In Dupuytren's (say "doo-pwee-TRAHNZ") contracture, the fascia of the palm of the hand becomes thick and tight. This causes the fingers to become stiff and to curl toward the palm. Removing the fascia can help relax the fingers.

This surgery may be done while you are asleep or while you are awake. If you are awake, you will get medicine to numb your hand and prevent pain. You may also get medicine to help you relax.

The doctor will make a cut, called an incision, in the skin of your palm. He or she will remove the thickened fascia. The doctor will close the incision in your palm with stitches. After surgery, you will have a scar on your palm and on one or more fingers. This will fade with time.

You will go home on the same day as the surgery. It will probably take about 6 weeks for your hand to heal. How soon you can return to work depends on your job. If you can do your job without using your hand, you may be able to go back in 1 to 2 weeks. But if your job requires you to do repeated finger or hand movements, put pressure on your hand, or lift things, you may need to take 6 to 12 weeks off work.

For the first few weeks after surgery, you will probably need to wear a splint. You may need to do hand exercises to help reduce the swelling and stiffness. After several weeks, your hand and fingers may be more flexible. You may be better able to fully open your hand.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery usually takes 30 minutes to 2 hours.
  • You will have a thick bandage on your hand, wrist, and fingers. You will not be able to move your finger.
  • You will probably go home after 1 to 2 hours in the recovery room.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Current as of: March 21, 2017