Pre-Operative, Operative, and Post-Operative Guide Lines

Abstract

There is a high tendency towards post-traumatic swelling of the hand and foot, which must be considered in the timing of the operation. Operation must either be carried out immediately, or after swelling has decreased, which means a delay of some days. Where operation is postponed, the skin of the operation site should on the eve of the intervention be disinfected with a sterile alcohol dressing which should, however, not entail a moist enclosure. Close attention must be paid to asepsis. Because of their shapes, disinfection of the hand and foot is difficult and unreliable. The use of a pressure gun which forces the disinfectant into the skin has proved to be most suitable for these parts. (Herold and Heim). This is of special importance since an adhesive plastic drape cannot be used on the hand. The movement of fingers, above all in flexion, must be constantly checked during the operation to avoid any rotational deformities. A bloodless field is provided by a pneumatic tourniquet; it should not be left in place for longer than two hours in younger patients.