Which elective hand surgery would benefit most from preoperative therapy interventions to enhance surgical outcomes? A survey of hand therapists.

Abstract

Background: An ageing population and increasing chronic health disorders explain the predicted rise in hand surgeries. Preoperative care has the potential to optimise patients' psychological and physical status, making it a promising area for enhancing surgical outcomes. Despite its established use in other surgical specialties, preoperative therapy in hand surgery remains underexplored.

Objective: This study uses an anonymous survey to gather therapists' opinions on the hand procedure whose outcomes benefit most from preoperative therapy. The research focuses on five common elective hand procedures: Carpal Tunnel Release (CTR); Cubital Tunnel Release (CuTR); Dupuytren's Fasciectomy (DF); Trapeziectomy (TZ); and Trigger Finger Release (TFR).

Method: British Association of Hand Therapy members were targeted in an online survey. Thirty-seven respondents (5% response rate) participated over 3 months. Questions explored how preoperative therapy improves surgical outcomes, the efficacy of postoperative therapy, and the importance of patient compliance postoperatively.

Results: TZ emerged as the procedure with the highest potential for preoperative therapy benefit, TZ and DF as top procedures for postoperative therapy requirements and importance of patient engagement and compliance. CTR had contradictory responses, while TFR and CuTR received the fewest endorsements for preoperative therapy benefits.

Conclusion: The survey offers insight into hand therapists' perspectives on preoperative therapy. TZ and DF stand out as having significant potential for optimisation. Uncertainty surrounding efficacy of therapy on Dupuytren's Disease indicates the necessity for further research. Education is considered an essential preoperative component. The small sample size warrants caution when interpreting results.