Erb’s Palsy: Care of your child following primary nerve surgery

How long does my child need to wear the
bandages?

Usually your child will need to wear the arm bandages for between 3-6 weeks depending on the surgery. At this time you will either have a face to face or video appointment to review your child. This will be specified below.

The date the arm bandages should be removed:

Your appointment will be face-to-face/video:

We would recommend that you remove the bandages a few hours before the video appointment.

Picture of a child with bandages after nerve graft surgery to their right arm.

What should I do if the bandages become loose?

You will be supplied with extra taping before you leave the ward. You can apply this over the original tape to hold the arm in position. If this still does not hold the arm in the correct position please contact the Children’s Plastics Dressing Clinic (CPDC).

What should I do if the bandages get wet?

You should try to keep the bandages dry. However if they do become wet we will need to reapply them. If this occurs please contact the Children’s Plastics Dressing Clinic (CPDC).

What are the signs of wound infection?

We will review the wound/scar during the appointment and you can discuss any concerns you have.

How do I position and look after my child when their arm is bandaged across their body?

The arm should feel secure within the bandages and not slip down, so it should not require any extra support.

You may benefit from using a babygrow, putting the arm inside, to keep the arm in position.

Picture of a child in a babygrow following nerve surgery.

What clothes can they wear?

You can adapt your childs clothing by cutting the side and using Velcro to stick it back together. Often buying clothes a size bigger will be helpful and make dressing easier. You can purchase specialist clothing from various websites.

How do I remove the bandages before my video appointment?

• Soak off the bandages in a warm, soapy bath for approx. 30-60 minute; please do not leave your baby unattended.
• Gently peel from the edge of the bandage until all bandages are removed.
• You can wash (soapy water) and handle the arm as normally.
• When drying the arm please pat dry rather than rubbing dry.

It is normal for the armpit to be reddened and wet – do not use any moisturising cream until 48 hours after the bandages are removed.

Please only do this if instructed. If you have been advised to attend a face-to-face appointment do not remove the bandages yourself.

Scarring

Photographs of healthy wounds, 4 weeks following primary nerve surgery.

Photograph of healthy wounds, 4 weeks following primary nerve surgery.

After a wound has healed, the scar will continue to alter as new tissue is formed. Scar tissue continues to mature for up to two years. During this time, it is important to perform scar massage and to protect the scar from the sun. This will prevent thickening/raised scarring and discolouration.

Massage can be started once the wound is fully closed and there are no open areas. There may be some stitches or scabs still present, which should fall away in the bath or when massage is started.

Use an un-perfumed moisturising cream or lotion eg. E45.

Gently massage the scar with a light pressure for at least 2-3 minutes, two times a day.

What will happen during my video appointment?

• This appointment will be with a Specialist Physiotherapist.
• We would like your child to be undressed down to their nappy.
• We need to assess your child’s movement in sitting and laying so can you please consider the environment you are in.
• It may therefore be easier to use a laptop rather than a phone and if possible have somebody with you to video. This will enable you to hold your child whilst we assess them.
• You will have opportunity to ask any questions regarding your child and surgery.

What exercises do I need to perform once the bandages have been removed?

We will want you to re-start the exercises that you initially performed before surgery. We will talk through the exercises during the video appointment.

Start slowly and gradually build up the stretch. We would expect that your child will have full joint movement passively (when you stretch the arm) by the time you return to clinic. Please note we do not expect that your child will have any extra movement from their surgery at this early stage.

How often do I need to do the exercises?

Ideally every nappy change.

Is there anything else I need to be careful with when handling my child?

No. Do not be afraid of handling your baby as you normally would, particularly during nappy changes. You will not cause any damage to your baby or stop the surgery from working.

Contact details

Leeds Teaching Hospitals Erb’s Palsy Website

For further information regarding Erb’s Palsy and exercise information, please visit our website by following the link below.