How to Approach Hand Wound Care, Tips for Occupational Therapists

Hi there! It’s Hoang Tran, and today, I want to dive into something that’s close to my heart—hand care. As a hand therapist, I’ve had the privilege of working with many patients, helping them recover from injuries, manage chronic conditions, and regain function. It’s not just about physical healing; it’s also about regaining confidence in your hands and your ability to do the things you love.

When a patient comes in with a wound—whether it’s fresh or weeks old—the first thing we need to consider is our approach. What do we say first? What do we do first? Our initial interaction sets the tone for their entire recovery process.

Building Trust from the First Conversation

No matter how severe or minor their injury is, patients are often anxious. The first thing I always do is reassure them. I introduce myself and explain everything I’m going to do before I do it. Imagine walking into an unfamiliar situation, not knowing what’s coming next. That’s how your patients feel. Even if they’ve been through this before, they don’t know exactly what to expect this time. They need to know that I’m here to help, not hurt them.

So, at the evaluation, I start with something like:
“Hey, my name is Hoang. I’m going to be your occupational therapist today. I see your hand is completely covered up. Tell me a little bit about what’s going on.”

Before even touching them, I want to hear their story. Getting a patient to talk about their injury can provide valuable insights, and it also helps them feel more comfortable. Once they’ve shared, I reassure them again:
“I just want to assure you, I’m going to tell you exactly what we’re doing so you’re not scared. I’m here to help, and we’re going to take this step by step.”

If you’re interested in gaining hand therapy certification, check out our comprehensive guide and certification programs.

Handling a Post-Op Dressing

If a patient has a post-op dressing, the first step is assessing their pain level. I might say something like:
“Oh, you just had surgery three days ago? Perfect, I’m so glad I know that. How are you feeling? What’s your pain like right now?”

If they’re in a lot of pain, I make sure to let them know that removing the bulky dressing might actually help them feel better. It’s important to reassure them that nothing I do is meant to make their pain worse—only to help.

I explain the process step by step:
“First, I’m going to remove the dressing so we can take a look at how things are healing. Then I’ll clean it, and we’ll decide what needs to happen next. We’ll start really easy and slow, staying in a pain-free range as much as possible.”

Removing the Dressing: Minimizing Pain and Anxiety

Once I start the actual removal process, I make sure the patient knows exactly what I’m doing and what’s coming next. The key here is stabilization—I want to minimize their movement to avoid unnecessary pain.

Important Steps to Follow:

• • Use scissors with a blunt edge to avoid accidental cuts.

• • Avoid pulling or tugging as much as possible.

• • If something is taped down or hard to remove, I cut it instead of pulling.

• • If dry blood is causing resistance, I pour saline over it to loosen it before gently pulling.

Patients need to trust me, and that starts with making sure their first experience in my care is as comfortable as possible.

Knowing Where the Incision Is

Before I even start cutting or removing anything, I make sure I know exactly where the incision is. If a patient sees scissors coming toward their wound, their first thought is: Oh no, they’re going to hit the area that hurts the most! To avoid that fear, I always use my finger to lift the dressing first, feeling underneath to find the safest place to cut.

If there’s padding or bulky gauze, I assess how it’s applied before I start pulling it off. Sometimes dressings are woven between fingers, making them trickier to remove without causing pain. Being mindful of these details makes all the difference.

Keeping Movement Minimal

One of the biggest mistakes is having the patient move too much while removing a dressing. The goal is to move them as little as possible. If they need to adjust their position, I make sure to do it in a way that prevents unnecessary discomfort. The less they move, the easier and less painful the process will be.

Watch My YouTube Video on Hand Therapy Techniques

For a deeper understanding of effective hand therapy techniques, check out my detailed YouTube video. I’ll walk you through essential exercises, treatment strategies, and clinical insights to help you improve patient outcomes. Watch it here: