This handout explains follow-up care after surgery to remove a ganglion cyst from either the dorsal (see Figure 1) or palmar (volar-see Figure 2) wrist. The ganglion is formed by the synovial or joint cell lining in the wrist. The surgery involves removing a ganglion as well as the stalk formed within the wrist joint. The splint is placed for your protection. It is okay to use your hand for light activities if you are comfortable. Because of the local anesthetic that we used, you may notice some numbness or tingling in your fingers for several hours after the surgery. Please see the instructions for pain management for additional details regarding the use of your postoperative medications, to avoid pain, nausea and constipation. The therapist in our office can help to remove the drain & transition you from the plaster splint to a removable brace in 5-7 days. If the incision is red or if there is drainage coming out of it, please call us right away. The phone number is listed on the bottom of this page. Go to the emergency room if this occurs at a night or on a weekend.

Wound Care:

  • After surgery, your hand and wrist will be covered by a dressing (bandage) and placed in a plaster splint that you will wear for five days. The splint helps protect the incision site and lessen the swelling.
  • Five days after surgery, you may remove all the dressings and splint from your incision. Put a small bandage over the incisions to keep them from getting caught on your clothes or other fabrics.
  • Do not put any ointment or lotion on your wound.
  • When bathing for the first five days of surgery, cover your hand with a plastic bag to keep the splint dry. After you remove the splint and dressing (five days after surgery) you may shower without covering the incision, but do not soak your hand in a bathtub, hot tub, kitchen sink, swimming pool, etc. In many cases, it will be helpful to have a therapist assist you with the splint removal and begin your exercise program.
  • Your wrist and palm may swell. Use an ice pack for up to 20 minutes at a time throughout the day over the surgical site to help ease the swelling. Be sure to place the thin cloth between your skin and the ice pack to protect your skin. Elevate your hand as much as possible each day to lessen the pain and swelling.

Pain Management:

  • You will receive a prescription for narcotic pain medication. Take your medication as directed. It is important to “stay ahead” of your pain medication and avoid having to play “catch up” for significant increases in pain. Medication for nausea will also be provided. Please make sure to take this as directed.
  • Please check with the postoperative nurses and the office staff at Bellevue Bone & Joint Physicians about how to manage your pain medication. To best manage your pain, you must take the pain medication the way it was prescribed, taking the correct dose at the right time.
  • If you have uncomfortable side effects from the pain medication, please call us at 425-462-9800.
  • Please see “medications after surgery” information form for more instructions.
  • It is normal to have some pain off and on for approximately one year after surgery particularly in cold weather.

Driving:

  • Do not drive if you are taking narcotic medications, as it is not safe. Taking medication can make you sleepy and delay your reaction time.
  • Once you are no longer taking narcotic medication, you may drive as soon as you can comfortably grip the steering wheel with both hands.

Activity:

  • You may use your hand for light activities such as getting dressed, typing, etc. Do not lift objects heavier than a soda can (about 1 pound or 0.45 kg) until your sutures have been removed.
  • Please avoid any heavy repetitive activities or heavy lifting such as weightlifting until four weeks after surgery.

Follow-Up:

  • Your sutures will be removed approximately 10-14 days after surgery. Your hand therapist will help assess your progress and teach you activities to lessen the scarring around your incision and increase your hand strength and range of motion.
  • After your sutures are removed, you can increase your activities as tolerated, but avoid heavy repetitive activities until four weeks after surgery.

Results:

Most patients who have ganglion surgery regain full use of their hand with excellent motion and strength.


Thomas E. Trumble, M.D.

*Figures courtesy of Principles of Hand Surgery and Therapy by Thomas E. Trumble, MD, Ghazi M. Rayan, MD, Mark E. Baratz, MD and Jeffrey E. Budoff, MD