Post-operative care for syndactyly release is very variable. Frequently, the sutures are absorbable and do not need to be removed and as such, division of simple syndactyly with no concerns about digital vascularity often means that the child has a dressing in place for a couple of weeks that covers the operative area. If there is a concern about digital vascularity then a lighter dressing is used that allows the monitoring of fingertip perfusion.
Frequently the child is too young to report pain but any indication of localised discomfort that is not controlled by simple analgesia should prompt consideration of whether the dressings are too tight - reduction is mandated with inspection of the digits. Similarly, after a couple of days a worsening of pain may indicate infection, particularly if it is combined with pyrexia and erythema extending proximal to the dressings. Again, reduction of the dressings is required.
After 10-14 days, the wounds are inspected and cleaned. Early finger exercises are commenced which may be largely passive regimens in the infant. The scars can be massaged with a simple emolient ointment by parents. If the wounds are slow to heal eg skin grafts that do not take, postoperative splinting may be required.
In the longterm, if a contracture develops with limitation of range of motion, consideration must be given to early surgical re-operation to prevent bone or joint deformity in the growing hand.
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