If the child’s fingertips or toes are visible, the ward nursing staff will check them on a regular basis for warmth, colour, sensation, movement and blood flow. Thechild’s limb may be raised using pillows or soft toys, or the hand may be placed in a sling when sitting or walking around.
Webbed hands and feet skin#
It also minimises any oozing under the flaps and skin grafts. It is best to keep the limb operated on raised above the level of the heart as much as possible to reduce any swelling, which in turn reduces any pain. The child will soon find a way to use their bandaged hand or foot in everyday activities. Their hand or foot will be covered in a large bandage to protect the skin grafts while they heal. The child will have had pain relief in theatre but when this wears off, pain relief will be given in the form of medicines to be swallowed. The child will come back to the postoperative ward to recover. There is a very small risk of nerve injury or of loss of the blood supply to the digit, but this is very rare with experienced surgeons. A second operation might also be needed if the scar does not stretch as well as the normal skin as thechild grows. If scarring is poor, then repeat surgery may be required when the child is older. If the child tends to scar easily from cuts and grazes, it is likely that they will have noticeable scars after the operation, but these will fade in time. The amount of scarring varies from child to child. Any infection or graft loss may affect the time the wounds take to heal and therefore the resulting scars. There is a chance that the skin graft will not ‘take’, but looking after it carefully will help the operation site to heal as well as possible. If an infection does occur, it is usually minor and easily treated with a course of antibiotics. There is a risk of infection as the skin is opened, but the child will be given antibiotics to reduce the risk of this. Are there any risks?Īround 150 major hand operations, including syndactyly repair, are carried out at GOSH each year and our surgeons are very experienced so will minimise the chance of any problems developing.Īs with all surgery, there is a risk of bleeding, but the surgeon uses a tourniquet to reduce blood flow to the operation site, so there is rarely any serious blood loss. The nurses will tell the parent when the child is in the recovery area and take them there. The child will be away from the ward for about one extra hour to give time to prepare for the operation, and to recover from the anaesthetic afterwards. Occasionally, a skin graft will not be needed. This will be a different colour on the hand than the rest of the skin. The skin for the graft is usually taken from the groin area, so that any scar is hidden in a natural skin crease. In most cases, the surgeon will need to use a skin graft to cover up any gaps. If a child’s palm is much lighter in colour than the back of the hand, this will be noticeable after the operation. This means that skin from the palm of the hand may end up on the back of the finger and vice versa.
Webbed hands and feet series#
This usually involves making a series of zig-zag incisions along the digits, and wrapping the zig-zag pieces of skin to cover up the inside surface of the digits where they were previously joined. The surgeon will recreate a new web with local flaps of skin from the sides of the digits. Syndactyly can also affect the toes, involving webbing of the skin or fusion of the underlying bones along part or the whole length of the toe. Occasionally it may be associated with extra digits or other abnormalities in the hands. Syndactyly can occur unilaterally (on one hand only) or bilaterally (affecting both hands), and can affect two or more fingers. In rare circumstances, it may occur along with other signs as part of a syndrome (collection of signs). Sometimes syndactyly occurs by chance or it may be inherited. Syndactyly happens when two or more fingers fail to completely separate during development. Hand development occurs in the early stages of pregnancy and the fingers separate in the ninth week. It is the second most common congenital hand problem and occurs in around 1 in 1,000 births. This may be along part or the whole length of the finger. Syndactyly means 'joined digits' and may involve webbing of the skin, or include fusion of the underlying bones.
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