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| Surgical
Closure / Post-Operative Care |
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Surgical Closure
- The tourniquet is dropped and hemostasis is
accomplished through a short period of compression.
If bipolar cautery is necessary, this can be performed
with retraction of the skin and subcutaneous tissue
and visualization with the endoscope. After obtaining
hemostasis, elevate the skin and insert a 20-gauge
Angiocath through the skin and into the wound
under direct visualization, taking care not to
injure the ulnar nerve. Withdraw the needle from
the Angiocath (leaving the Angiocath) and tightly
close the skin with absorbable subcuticular sutures,
followed by Steri-Strips. Tight closure is mandatory
due to considerable stress placed on the incision
during postoperative range of motion exercises.
Following closure, infiltrate (if no contraindications)
with 15-20 cc of 0.25% Marcaine with Epinephrine
through the Angiocath, which is then removed.
Standard soft postoperative dressing is applied
with compressive Ace.
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Post-Operative Care
- The patient is instructed prior to surgery for
active and passive range of motion of the elbow
with the expectation of having full range of motion
on the first postoperative visit in 7-10 days.
The patient is instructed to de-bulk the dressing
as necessary to allow for full range of motion.
Patients are allowed to return to full activity
as tolerated, with many patients obtaining full
or near full activity by the end of the first
week.
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