Recovery after Dupuytren's fasciectomy: stage by stage

Two NHS trust leaflets feed this page and they disagree on some dates, notably driving, which Cambridge places at about two weeks and Worcestershire at four. The differences reflect local protocols and the fact that the extent of surgery varies, from one finger to several, and with or without a skin graft. Your surgeon and hand therapist set the actual plan.

The operation itself, and the alternatives of needle fasciotomy and collagenase injection, are covered in the guide to Dupuytren's fasciectomy. This page covers what comes after.

Worcestershire advises supporting the hand on cushions or pillows with the hand higher than the heart to help swelling go down, and taking painkillers before therapy sessions, since the therapist will be moving the fingers. Some numbness or tingling is expected and should settle over time, according to the same leaflet, and Cambridge says some numbness and swelling are normal.

Wash with unperfumed soap or wipes and avoid washing across any unhealed wound, and cover the hand with a plastic bag in the shower until wounds have healed, says Worcestershire. Cambridge says to begin washing the hand once the wound is fully closed or healed, starting with running water and avoiding soaking.

Contact your GP for redness, increasing swelling, a change in pain or discoloured discharge, which Cambridge lists as signs of infection.

Movement starts early. Cambridge gives seven active and four passive finger exercises, and says tightness is expected unless you feel sharp pain. Worcestershire describes week-one exercises of making a fist, touching the thumb to each fingertip and spreading the fingers, with tendon-gliding exercises added from week two, while keeping the shoulder, elbow, wrist and unaffected fingers moving to prevent stiffness.

If a splint is requested, both leaflets say it is worn at night only unless the therapist advises otherwise, and Cambridge says it can be worn for up to twelve months, since the hand should be used normally by day. The amount of therapy depends on how easily the fingers move.

Cambridge puts driving at about two weeks, when the wound is healed, sutures are out and you can confidently hold the wheel, while Worcestershire says to return to manual work, sport and driving four weeks after surgery. Until then, avoid lifting and activities needing power grip, as Worcestershire advises. GOV.UK says to ask your doctor if you are unsure and to tell the DVLA if you are still unable to drive three months after an operation, and your insurer expects you to be in full control.

For work, Cambridge says 1 to 3 weeks for light work and 4 to 8 weeks for heavy manual work, and says most people use the hand normally at around 10 to 21 days. A job with vibration or heavy grip may need the longer period.

• Keep the hand raised when resting in the first days.

• Do exercises little and often, not in one long session.

• Ask your therapist before returning to gardening, DIY or sport.

Cambridge says to begin scar massage 24 to 48 hours after stitches are removed, using an unperfumed moisturiser in small circular movements along the scar. Worcestershire says the therapist will teach you once the wounds are fully healed and sutures are out, to keep the hand and scar tissue flexible. The active scar phase lasts 12 to 18 months or more at Cambridge.

Contact your GP or the hand clinic promptly for spreading redness, heat, increasing pain or swelling, discoloured discharge or a fever. Use NHS 111 out of hours. A finger that becomes cold, white or blue, or sudden loss of feeling, needs urgent assessment at an emergency department.