Your dressing & incision care

Dressing instructions depend on which procedure you had, so find yours below rather than following a single rule.

Replacements and non-arthroscopic shoulder surgery
Your waterproof dressing stays on for 5 days, then you can remove it. You can shower with it on. There is an adhesive strip underneath the dressing, leave that in place. It comes off at your first post-operative appointment.
Shoulder or elbow arthroscopy
Remove the clear dressings and gauze after 48 hours. There is no need to re-dress the site. Slight drainage is normal, cover it with gauze or a plaster if needed.
Elbow fracture surgery
If you have a splint, a half cast, keep it on until your post-operative appointment. If you have a soft dressing with an ACE bandage, that may come off after 48 hours.

Once the dressing is off, shower by letting water run over the site and pat it dry. No scrubbing until your 2-week appointment.

Protecting the repair

Rapid Recovery Protocol

Managing pain after surgery

Dr. Cohn uses multimodal analgesia, several medications working together at lower doses to give better relief than any one of them alone. Your prescriptions are sent before surgery, and your written instructions tell you exactly what to take and when.

Pain relief.
A scheduled combination started the morning after surgery, so you stay ahead of the pain, plus a stronger option for the first few days if you need it.
Anti-inflammatory.
Reduces swelling and the discomfort that comes with it, taken alongside something to protect your stomach.
Nausea.
Common in the first days, usually from taking medication on an empty stomach. You will have something on hand for it.
Constipation.
Very common alongside stronger pain medication, and easier to prevent than to fix.

Staying Comfortable

Icing, sleeping, and daily life

The first two weeks are the ones that need planning. These are the things that make the biggest difference.

Ice, 20 on and 20 off

For the first week, ice the surgical area 20 minutes on and 20 minutes off, as often as you can manage. Ice packs or a cold therapy machine both work.

Ice before bed

Twenty minutes before you turn in calms things down as you fall asleep.

Sleep semi-upright

A recliner, a wedge pillow, or pillows behind your back keeps you propped up, which is more comfortable and reduces swelling. Most patients need this for the first week or two, then move back to a regular bed.

Support the arm

Rest the operative arm on a pillow at your side, or place one behind the elbow to keep it forward. After elbow surgery, prop it on a soft pillow while side-lying to avoid bending stress.

Imperfect nights are normal

Expect a few broken nights early on. It is normal, it is temporary, and it improves week by week.

Showering one-handed

Pump-handle shampoo, a long-handled sponge, and a shower chair all make bathing easier while you have one arm.

Washing the operative side

Remove the sling and let the arm hang. To reach the armpit on that side, lean your body forward to open the space.

Eat for healing

Protein matters most for tissue repair, so eggs, chicken, fish, beans, or shakes. Vitamin C and zinc support collagen, and small frequent meals keep energy up without much cooking.

Most of the items above are on Dr. Cohn's supply list

What To Expect

Common experiences after surgery

Patients often wonder whether what they are feeling is a problem. Almost always, it is part of healing.

Swelling and bruising in the shoulder, arm, or even the hand are completely normal, gravity pulls fluid downward after surgery. Prop the arm above waist level on pillows while resting. Swelling usually peaks in the first week and fades over 2 to 3 weeks
Numbness or tingling in the arm for 24 to 72 hours means the nerve block is working, and it fades as the block wears off
Stiffness, or a locked-up feeling, is common after repairs and fractures. It is your body protecting the site. Gentle therapy helps once you are cleared, do not force it
A little redness at the incision, and minor clear or pinkish drainage, are normal for the first few days
Mild clicking or popping as you start moving is usually harmless and settles with time

While you are in the sling

Start these as soon as the nerve block wears off, 15 repetitions each, at least three times a day, at breakfast, lunch, and dinner. They maintain motion and reduce swelling.

Bend the arm at the elbow as far as possible, then straighten it as far as possible
Rotate the forearm so the palm faces up, then turn it so the palm faces down
Raise the wrist upward as far as possible, then lower it, using your other hand to help with the stretch
Make a fist, then open the fingers as widely as possible. An exercise ball works well if your sling came with one

Sling fit note:

Adjust the sling so that when you are standing, your wrist sits at the level of your belly button. If your sling has a pillow between your torso and arm, an Ultrasling for example, that pillow is optional and can be removed from its velcro if it feels bulky. Wearing the sling to sleep is not required, remove it if that is more comfortable.

We're here

When to call the office

Call us rather than heading to the emergency room or urgent care. Our team will tell you the right next step, and if you need to be seen in the evening we will direct you to a colleague who knows Dr. Cohn's protocols.

Swelling that worsens, or feels tight and painful
Redness that spreads, drainage that turns yellow or green, or any odd smell
Pain that is not improving despite your medication
Numbness that lasts beyond 72 hours, or new numbness that appears after the block has worn off
Fever over 101.5°F, or chills
Calf pain or swelling in either leg

Athena patient portal, or call (908) 277-8704, extension 6. Dr. Cohn directly: Mcohn2@summithealth.com. Day or night, for urgent needs, problems, or questions.

Recovery