Hand surgery is a speciality that is performed by either orthopaedic surgeons (bone doctors) or plastic surgeons. The beauty of hand surgery is that it is a combination of bone work (like fractures of bones) and reconstruction of soft tissues (skin, tendons, nerve and muscle and blood vessels). These are usually very intimately related and most hand surgeons have done extra training in order to equip them to manage these intricate surgical procedures.
Dr van der Spuy’s practice is geared to manage a wide range of problems, including managing fractures of the upper limb, general lumps or pinched nerves, micro-surgical repair of damaged nerves or blood vessels and soft tissue reconstruction. His practice would manage traumatic injuries like fractures, lacerations or joint dislocations, chronic conditions like arthritis (osteoarthritis or rheumatoid arthritis), gout, as well as the management of the less common congenital hand anomalies.
Dr van der Spuy also offers a super specialised service catering for the needs of sportsmen and musicians.
Physiotherapists and occupational therapists play an important role in the management and rehabilitation of many of these problems. Dr van der Spuy therefore works closely with them.
The risk of bleeding in hand surgery procedures is fairly low. We tend to stop certain blood thinning medications like Disprin (aspirin), Plavix (clopidrogrel) or Warfarin before elective procedures. We weigh the benefit up against the risks of stopping certain medications. Some Warfarin patients might need to be pre-admitted to change to a blood-thinning drug (Heparin) that can be adjusted more readily. Disprin is an anti-platelet drug and should be stopped a week before the procedure. Please discuss this in your consultation with Dr van der Spuy to formulate a plan.
The most important thing to note before an operation is to be fasted for six hours by the time you have the operation. This is to ensure that there is no stomach content that can be aspirated in the lungs at the time of the operation. You will be advised to be fasted (fluids and solids) from the night before if your operation is performed in the morning. Afternoon cases can usually have an early breakfast or coffee/rusks depending on the time of the scheduled case. Please enquire if you are uncertain.
Please continue your normal chronic medications (like anti-hypertensives) the day of the operation. You can take it with a small sip of water.
There are a few preparations that you have to consider before the surgery. Any shaving of hair required will be done in theatre. Please remove all nail polish and make sure that nails are clean and cut. If you are living alone consider the fact that it will be a challenge to fulfil your normal daily activities from preparing food to basic hygienic activities. Make sure you prepare for this.
Driving might be difficult in most cases post-operatively especially if the limb is immobilised in a cast. You might have to speak to your insurer. Please make arrangements for someone to pick you up from the hospital after the procedure.
Finally, most patients get booked off from work for a period of recovery. This period will be discussed between you and Dr van der Spuy and will depend on the type of work that you do and the kind of operation that was done. Please advise the practice if you require specific letters for your employer before the operation.
Finally, make sure that you have a nice book to read after the operation. You don’t always get a pass for leisure time like this!
Here are a couple of guidelines that will help you through the post-operative recovery period. Please read these and ask personnel if you are uncertain on any of the following. Please visit our website www.capehandsurgery.co.za for more detail on your procedure or for any other information. Please feel free to leave a comment or tell us about your experience on the patient blog. This might be useful for other patients going through the same process. For further enquiries, please email the practice at email@example.com