Operation Note (Ortho)

Procedure

A right carpal tunnel decompression was performed under local anaesthesia using 10 mL of 1% lidocaine with adrenaline. A high-arm tourniquet was inflated to 250 mmHg after limb exsanguination. A 3 cm longitudinal palmar incision was made in line with the radial border of the ring finger. The palmar aponeurosis was incised longitudinally, and the transverse carpal ligament was fully divided under direct vision to decompress the median nerve. Haemostasis was achieved following tourniquet release after 12 minutes.

Closure

The wound was irrigated thoroughly with 0.9% normal saline. Skin closure was achieved using interrupted 4-0 nylon vertical mattress sutures. Sterile dressing pads and a bulky wool and crepe bandage were applied to the right hand and wrist. Distal capillary refill was confirmed to be less than 2 seconds across all digits.

Post-Op Instructions

The patient is advised to keep the limb elevated in a Bradford sling for the first 48 hours and to commence immediate active mobilisation of the fingers. The bulky outer bandage may be reduced after 72 hours, though the inner adhesive dressing must remain dry and intact. A practice nurse appointment should be arranged for suture removal in 10 to 14 days. Analgesia is prescribed as paracetamol 1,000 mg PO QID PRN and ibuprofen 400 mg PO TID PRN, with routine outpatient clinic review scheduled in 6 weeks.