Acute Hand Laceration " Jenn is a 37-year-old who cut her thumb and index finger "

Case study ( 6411 views as of December 12, 2024 )

Jenn is a 37-year-old who was cleaning up after a party in her home. She reached into the dishwasher without realizing that a wine glass had broken, and cut her hand between her thumb and index finger.

It initially bled a fair bit, but she was able to stop the bleeding in a few minutes with some direct pressure from an available dish towel. She bandaged it up with some gauze and cling wrap from her first aid kit at home, thinking that it wasn’t going to require any stitches. Later that evening though, she became concerned when she noticed blood soaking through the dressing, and realized that she had some numbness to the side of her index finger.

When such injuries occur, one should consider the possibility of injuries to underlying structures. Jenn could consider calling 811 (the Nurse Advice Line), going to an Urgent Care Clinic or the closest Emergency Department. Once a full assessment has been completed, Jenn may be referred to a plastic surgeon, hand physiotherapist or bracing and support specialist. A First Aid Supply Store, Medical Supply Store and/or pharmacy may carry many of the products she could use to manage the injury.

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Conversation based on: Acute Hand Laceration " Jenn is a 37-year-old who cut her thumb and index finger "

Acute Hand Laceration " Jenn is a 37-year-old who cut her thumb and index finger "

  • If you develop symptoms of carpal tunnel syndrome and your diagnosis has been confirmed by your family physician, additional tests such as a nerve conduction study may be recommended to assess the degree of nerve slowing. However, not all doctors require a positive nerve test to make the diagnosis if you have classic symptoms of carpal tunnel syndrome. In the early stages of the disease, your physician may recommend wearing a brace at nighttime to keep your wrist in a straighter position. They may also advise you to avoid extreme wrist positions during the daytime, such as extension or flexion, especially during work or activities that involve prolonged gripping. Anti-inflammatories may be prescribed to help alleviate symptoms, and in some cases, cortisone injections into the carpal canal may provide temporary relief. It's important to understand that carpal tunnel syndrome is a progressive condition that can worsen over time. While allied health professionals can help manage symptoms and potentially delay the need for surgery, if you experience daily symptoms and find that conservative measures are no longer effective, it may be advisable to consult with a surgeon who specializes in carpal tunnel syndrome. Surgical treatment aims to release the tight ligament causing the compression in the carpal tunnel. There are two main techniques: the traditional approach involves making a small incision over the ligament and cutting it, while the endoscopic approach involves using a camera to cut the ligament from the inside of the tunnel. Both techniques have similar outcomes. If you suspect you have carpal tunnel syndrome, it is recommended to seek attention from your family doctor for confirmation of the diagnosis and appropriate treatment.
  • I would assume getting checked for small shards of glass would be a good idea in a deep cut. If you didn't see the glass break, it would be hard to see if it was a clean break or if any small shards were present when her hand touched the glass.
    • That's a good point Michelle. Generally when glass breaks we're forever picking up tiny slivers. It would make sense to have a laceration looked at to make sure there isn't anything inside
  • A cut or laceration between your fingers must be one of the worst places to get one. Not only does it hurt more but they seem to take longer to heal
    • They definitely seem to take longer to heal since it's right in that space that is difficult to bandage up and is always getting stretched to re-open the wound.
  • Does the amount of bleeding indicate the severity of the cut or is the length of time it bleeds the better indicator?
    • During first air training we were told to follow this general rule of thumb: if the wound bleeds excessively, if it is deeper than a 1/4 inch, if it is longer than 1 inch, wounds on the face. You should also have a doctor look at wounds on or near a joint
    • How do you know when stitches are needed ?
    • I think it's a little of both. If a laceration bleeds for an extended period of time and / or a wound seems to be bleeding excessively rather than sluggishly , it could require medical attention.
  • What makes the numb feeling?
    • If there is damage to nerves or tendons, what would next steps be ? Can the damage be reversed ?
    • It could indicate that the wound is more than just a surface laceration and there might be damage to the nerves / muscles / tendons etc.
  • How does one know how severe a wound is ? A delayed reaction of bleeding may have you believe it is a small cut and nothing is wrong ?
    • Generally if a wound continues to bleed an hour after injury you should seek further treatment. Numbness or a "cold" feeling around the wound are also indicators to seek medical assistance
  • It's not usually a specialist to see after a hand laceration or injury, but a hand physiotherapist can help with regaining hand flexibility and function. My husband broke a finger a few years ago and his physiotherapist helped him regain finger function.
    • Good point. The article mentions she was experiencing some numbness to the side of the finger. This could mean she has nerve damage. A hand specialist would help with the healing process
  • Drinking alcohol and some medications can delay clotting and result in bleeding for a longer period of time. When seeing a physician about a wound that won't stop bleeding, try to recall all of the medication you've recently taken.
    • I believe fish oils act as blood thinners as well.
    • Are there foods that interfere with the body's ability to clot wounds ?
  • Sounds like this wound was deep and would require medical attention, possibly stitches
  • Numbness could indicate that she nicked a nerve. Cuts in the space between the thumb and index finger always seem to take longer to heal because of how much movement is in that area
  • It's very easy to think an injury will be fine when in fact it requires medical attention
  • While everyone should learn the basics of aseptic techniques to treat wounds and injuries, Dr. Taylor makes an important point about bleeding. First priority is to stop the bleeding and to get medical attention for a wound that hasn't stopped bleeding or is considered to be serious. For minor wounds, keep it clean after the bleeding has stopped and monitor to see if it is healing well.
    • What is a "normal" amount of bleeding after an injury like this?
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