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Infected splinter in thumb: Splinter, First Aid: Condition, Treatments, and Pictures – First Aid Guide

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Splinter, First Aid: Condition, Treatments, and Pictures – First Aid Guide

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First Aid

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Overview

A splinter, or sliver, is a particle of a foreign object, such as a small piece of wood, that has embedded itself in ones skin. Splinters can sometimes come out on their own or be pulled or milked (by gently squeezing on each side of the splinter) out easily, but others can be deeply embedded and difficult to remove. All splinters should be removed as promptly as possible. If a splinter becomes wet, it makes the area prone to infection.

First Aid Guide
Self-care measures to remove a splinter are as follows:

  1. Wash your hands.
  2. Clean tweezers and a needle by boiling them or by pouring antiseptic solution (eg, isopropyl alcohol) over them, and let them dry.
  3. With the tweezers, attempt to pull the splinter out the same direction and angle that it went in the skin.
  4. If the splinter cannot be removed by the tweezers because the tip is not accessible, use the needle to make a small hole above the splinter and/or use the needle to lift the splinter out.
  5. Once the splinter is fully out, wash the area and bandage it with a clean, dry dressing.

Note: If the splinter is embedded in the skin under the nail, you can cut a V-shaped notch in the nail to improve access to the area.

Who’s at risk?

Splinters are very common and affect all people. Those who are exposed to unfinished wood or machines that produce slivers of wood or metal are most prone to splinters.

Signs and Symptoms

Splinters appear as an often small sliver of a foreign object, either fully or partially embedded into a person’s skin. Splinters can be small, large, smooth, jagged, deeply embedded, or only partially embedded. If the sliver is large or jagged, there may be bleeding and redness of the affected area. There may be no bleeding if the sliver is small or fairly smooth.

Slivers often occur on the hands and feet, but they can occur anywhere on the skin or eye that comes in contact with a sliver of a foreign object. Note: For splinters in the eye, see the topic Foreign Object in Eye or Skin.

When to Seek Medical Care

Seek medical care if:

  • You are unable to remove the splinter or only part of a splinter was successfully removed by self-care measures and there is still a piece of the sliver in the skin.
  • The skin around the splinter is particularly red, painful, swollen, or bloody.
  • The site of a splinter appears to be infected (ie, it is increasingly painful or red, swollen, there is discharge, there is associated fever or swollen lymph nodes, or there is red streaking from the affected area toward the heart).
  • Tetanus immunization is not up to date.

Treatments Your Physician May Prescribe

The physician will ensure that the splinter site is clean and free of debris.

If tetanus immunization is not up to date (ie, it has been more than 10 years since the last immunization), the physician will need to give a tetanus vaccine and booster promptly. (A tetanus immunization is only effective if given within 72 hours of trauma.) If you have had a tetanus vaccination within the last 5 years but the sliver came in contact with dirt or animal feces before it punctured the skin or the sliver is particularly deep or jagged, the physician may give a new tetanus vaccine and booster.

If the splinter site has become infected, the physician may need to treat the infection with antibiotics.

Trusted Links

MedlinePlus: Foreign Bodies

Sliver or Splinter

Is this your child’s symptom?

  • A foreign object stuck in the skin
  • Some examples are a wood splinter, fishhook, glass sliver or needle

Symptoms of a Foreign Object in the Skin

  • Pain. Most tiny slivers in the top layer of skin do not cause much pain. An example of these tiny slivers is plant stickers. Objects that are deeper or go straight down are usually painful to pressure. Objects in the foot are very painful with standing or walking.
  • Foreign Object Sensation. Older children may complain about something being in the skin. (“I feel something in there.”)

Types of Foreign Bodies (Objects)

  • Wood (Organic): splinters, cactus spines, thorns, toothpicks. These objects are irritating and become infected if not removed.
  • Metallic: BBs, nails, sewing needles, pins, tacks
  • Fiberglass slivers
  • Fishhooks may have a barbed point that makes removal difficult
  • Glass sliver
  • Pencil lead (graphite, not lead)
  • Plastic sliver

When to Call for Sliver or Splinter

Call Doctor or Seek Care Now

  • Object is a BB
  • Object is causing severe pain
  • You want a doctor to take out the object
  • You tried and can’t get the object out
  • Wound looks infected (spreading redness)
  • Fever occurs
  • You think your child has a serious injury
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Deep puncture wound and last tetanus shot was more than 5 years ago
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Tiny, pain-free slivers near the surface that don’t need to be removed
  • Tiny plant or cactus spines or fiberglass slivers that need to be removed
  • Minor sliver, splinter or thorn that needs removal. You think you can do it at home.

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Minor Slivers and Splinters

  1. Tiny, Pain-Free Slivers – Treatment:
    • Tiny, pain-free slivers near the skin surface can be left in.
    • They will slowly work their way out with normal shedding of the skin.
    • Sometimes, the body also will reject them by forming a little pimple. This will drain on its own. Or you can open up the pimple. Use a clean needle. The sliver will flow out with the pus.
  2. Tiny Painful Plant Stickers – Treatment:
    • Plant stickers or cactus spines are hard to remove. Fiberglass slivers may also be hard to get out. Reason: They are fragile. Most often, they break when pressure is applied with a tweezers.
    • Tape. First, try touching the spot lightly with tape. The stickers should attach to the tape. You can use packaging tape, duct tape or another very sticky tape.
    • Wax Hair Remover. If tape doesn’t work, use wax hair remover. Put a thin layer on. Let it air dry for 5 minutes. You can also speed up the process with a hair dryer. Then peel it off with the stickers. Most will be removed. The others will usually work themselves out with normal shedding of the skin.
  3. Needle and Tweezers for Slivers and Splinters:
    • For larger splinters, slivers or thorns, remove with a needle and tweezers.
    • Check the tweezers first. Be certain the ends (pickups) meet exactly. If they do not, bend them. Clean the tool with rubbing alcohol before using them.
    • Clean the skin around the sliver briefly with rubbing alcohol. Do this before trying to remove it. If you don’t have any, use soap and water. Caution: Don’t soak the spot if the foreign object is wood. Reason: can cause swelling of the splinter.
    • Use the needle to uncover the large end of the sliver. Use good lighting. A magnifying glass may help.
    • Grasp the end firmly with the tweezers. Pull it out at the same angle that it went in. Get a good grip the first time. This is important for slivers that go straight into the skin. This is also important for those trapped under the fingernail.
    • For slivers under a fingernail, sometimes part of the nail must be cut away. Use a fine scissors to expose the end of the sliver.
    • Slivers (where you can see all of it) often can be removed at home. Pull on the end. If the end breaks off, open the skin with a sterile needle. Go along the length of the sliver and flick it out.
  4. Antibiotic Ointment:
    • Wash the area with soap and water before and after removal.
    • Use an antibiotic ointment (such as Polysporin) once after sliver is taken out. No prescription is needed. This will help to decrease the risk of infection.
  5. Call Your Doctor If:
    • You can’t get the object out
    • Object is out, but pain gets worse
    • Starts to look infected
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 05/30/2021

Last Revised: 03/11/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Splinter Removal – American Family Physician

CHRISTINA CHAN, M.D., and GOHAR A. SALAM, M.D., D.O., Michigan State University College of Human Medicine, East Lansing, Michigan

Am Fam Physician. 2003 Jun 15;67(12):2557-2562.

Splinter injuries are common, but larger and deeper splinters are often difficult and painful to remove at home. These splinters often present as a foreign body embedded in the superficial or subcutaneous soft tissues. Whenever possible, reactive objects like wood, thorns, spines, and vegetative material should be removed immediately, before inflammation or infection occurs. Superficial horizontal splinters are generally visible on inspection or easily palpated. A horizontal splinter is exposed completely by incising the skin over the length of the long axis of the splinter, and removed by lifting it out with forceps. A subungual splinter may be removed by cutting out a V-shaped piece of the nail. The point of the V is at the proximal tip of the splinter, which is grasped and removed, taking particular care not to push the splinter further into the nail bed. Removal of an elusive splinter can be challenging and may require the use of imaging modalities for better localization. Deeper splinters, especially those close to important structures such as nerves, tendons, blood vessels, or vital organs, should be referred for removal.

Splinters are common in children and adults, most often presenting as a foreign body embedded in the superficial or subcutaneous soft tissues of the extremities. Wood, glass, and metallic splinters are among the most common retained foreign bodies.1 Most superficial splinters may be removed by the patients themselves, leaving to physicians only the deeper and larger splinters, or retained splinters that have broken down during an attempt at removal.2 If not removed completely, splinters may cause complications such as inflammation, infection, toxic reactions, and granuloma formation. Failure to diagnose the foreign body has emerged as a common cause of malpractice actions against family physicians. Even after a foreign body has been found, the physician should ensure that nothing is left in the wound. The physician also must be cautious in telling the patient that the splinter is entirely removed. It may be preferable to tell the patient that all of the visible splinter has been removed, but there is always a chance that small pieces may be present that are undetectable at that time.

Evaluation

The most common error in the management of soft tissue foreign bodies is the failure to detect their presence.2,3 A patient’s suspicion that a foreign body may be present must be taken seriously. It is important to obtain a careful history, inquiring about the nature and timing of the injury, the composition of the material most likely involved, and the presence of any foreign-body sensation in the wound if the splinter is not readily visible. It is also important to ask about, and document, the tetanus immunization status of the patient.

The timing of the injury is important in evaluating splinters. A fresh injury usually has an injury track leading to the splinter that facilitates its detection and removal. Older injuries may present as infection, inflammation, induration, or granuloma formation, sometimes with no apparent history of foreign-body exposure. The composition of the foreign body dictates the reaction of the tissues to the splinter. Some types of foreign material are more toxic and allergic than others (Table 1). 3,4 Wood, thorns, spines, and other vegetative foreign bodies are considered highly inflammatory, whereas glass, metal, and plastic are relatively inert materials.5

View/Print Table

TABLE 1

Reactions to Retained Foreign Materials
Type of material Reaction severity Reaction type

Glass (uncontaminated)

Mild

Encapsulation

Blackthorns

Severe

Inflammatory reaction from alkaloids

Wood

Severe

Infection, inflammatory reaction from oils and resins

Cactus spines

Moderate to severe

Inflammation from fungal coating on the plant; delayed hypersensitivity reaction

Rose thorns

Moderate to severe

Inflammation from fungal coating on the plant

Sea urchins

Moderate to severe

Inflammation and infection; toxic and allergic reaction

Metal

Mild

Encapsulation

Plant spines (alkaloids)

Mild to severe

Toxic reaction

Animal spines

Mild to severe

Toxic reaction

Plastic

Mild

Encapsulation

TABLE 1

Reactions to Retained Foreign Materials
Type of material Reaction severity Reaction type

Glass (uncontaminated)

Mild

Encapsulation

Blackthorns

Severe

Inflammatory reaction from alkaloids

Wood

Severe

Infection, inflammatory reaction from oils and resins

Cactus spines

Moderate to severe

Inflammation from fungal coating on the plant; delayed hypersensitivity reaction

Rose thorns

Moderate to severe

Inflammation from fungal coating on the plant

Sea urchins

Moderate to severe

Inflammation and infection; toxic and allergic reaction

Metal

Mild

Encapsulation

Plant spines (alkaloids)

Mild to severe

Toxic reaction

Animal spines

Mild to severe

Toxic reaction

Plastic

Mild

Encapsulation

On physical examination, most superficial splinters can be visualized or palpated easily. Deeper splinters may be difficult to detect; at times, the only clue to the presence of retained foreign bodies may be swelling, tenderness, a mass, a draining sinus, or a soft tissue infection such as cellulitis, abscess, lymphangitis, bursitis, synovitis, arthritis, or osteomyelitis. While evaluating the patient with skin or soft tissue complaints, the physician should actively look for signs of a hidden foreign body (Table 2).3,4

An array of diagnostic tools is available for detecting and locating splinters (Table 3).3,4,6–11 The cost of an imaging modality and its likelihood of detecting the foreign body should be considered before it is ordered. Standard radiographs are the most practical means of screening for a radiopaque foreign body.3 Almost all glass is radiodense, and glass foreign bodies as small as 0.5 to 2 mm can be detected easily on plain radiographs.

View/Print Table

TABLE 2

Signs of a Hidden Foreign Body

Puncture wound

Blood-stained injury track of a fresh wound

Sharp pain with deep palpation over a puncture wound

Discoloration beneath the epidermis

Wound that elicits pain with movement

Wound that fails to heal

Abscess (with sterile culture)

Pain associated with a mass

Mass under the epidermis

Chronically draining purulent wound

Cyst

Granuloma formation

Sterile monoarticular arthritis

Periosteal reactions

Osteomyelitis

Pseudotumors of bone

Delayed tendon or nerve injury

TABLE 2

Signs of a Hidden Foreign Body

Puncture wound

Blood-stained injury track of a fresh wound

Sharp pain with deep palpation over a puncture wound

Discoloration beneath the epidermis

Wound that elicits pain with movement

Wound that fails to heal

Abscess (with sterile culture)

Pain associated with a mass

Mass under the epidermis

Chronically draining purulent wound

Cyst

Granuloma formation

Sterile monoarticular arthritis

Periosteal reactions

Osteomyelitis

Pseudotumors of bone

Delayed tendon or nerve injury

On the other hand, wooden splinters are usually difficult to detect on plain radiographs unless there is paint on the wood that contains lead or other radiopaque substances. 6 In most cases, two radiographic views may be adequate, but an oblique view may be more revealing and is readily obtainable. Computed tomographic (CT) scanning and magnetic resonance imaging (MRI) detect many foreign bodies that may be missed on radiographs and are particularly helpful in detecting wooden splinters lodged near bones.7 Although wooden splinters may be visible at an early stage on a CT scan, they soon become isodense with the adjacent tissue as the wood absorbs water. Sonography provides an excellent alternative method for identifying and localizing radiolucent foreign bodies.8–13 A 7.5-MHz probe is used to search for small, superficial objects, whereas a 5.0-MHz probe is recommended for larger, deeper objects.

Splinter Removal

When possible, reactive objects should be removed before inflammation or infection occurs. Wood, thorns, spines, and other vegetative foreign bodies should be eliminated immediately, but glass, metal, and plastic can be removed in a less restricted time frame. 13 Small elusive splinters may be located more easily once they have become encapsulated by granulomatous or scar tissue.14

Proper preparation and setup include adequate lighting, anesthesia, magnification, and a bloodless, sterile field.4 The physician must resist the temptation to remove the splinter by simply pulling it out of the wound because this may leave small fragments behind.

View/Print Table

TABLE 3

Comparison of Diagnostic Tests for Detection of Foreign Bodies
Material Plain radiographs High-resolution ultrasound scans Xeroradiographs CT scans MRI

Wood

Poor

Good

Superior to plain radiograph

Good

Good

Metal

Good

Good

Good

Good

Poor

Glass

Good

Good

Good

Good

Good

Organic (thorns, spines)

Poor

Good

Superior to plain radiograph

Good

Good

Plastic

Moderate

Superior to plain radiograph

Good

Good

Palm thorn

Poor

Moderate

Poor

Good

Good

TABLE 3

Comparison of Diagnostic Tests for Detection of Foreign Bodies
Material Plain radiographs High-resolution ultrasound scans Xeroradiographs CT scans MRI

Wood

Poor

Good

Superior to plain radiograph

Good

Good

Metal

Good

Good

Good

Good

Poor

Glass

Good

Good

Good

Good

Good

Organic (thorns, spines)

Poor

Good

Superior to plain radiograph

Good

Good

Plastic

Moderate

Superior to plain radiograph

Good

Good

Palm thorn

Poor

Moderate

Poor

Good

Good

SUPERFICIAL HORIZONTAL SPLINTERS

Superficial horizontal splinters are generally visible on inspection or easily palpated. The skin overlying the splinter is cleaned with povidone-iodine solution (Betadine) and infiltrated with 1 to 2 percent lidocaine with epinephrine (Xylocaine with epinephrine). Using a no. 15 scalpel blade, the skin is incised over the length of the long axis of the splinter, completely exposing it. The splinter is then easily lifted out with the blade or a forceps, and the track is cleaned with normal saline or povidone-iodine solution (Figure 1).

View/Print Figure

FIGURE 1.

Removal of a superficial horizontal splinter. Using a no. 15 scalpel blade, the skin is incised over the length of the long axis of the splinter, completely exposing it. The splinter is then lifted out with the blade or a forceps.


FIGURE 1.

Removal of a superficial horizontal splinter. Using a no. 15 scalpel blade, the skin is incised over the length of the long axis of the splinter, completely exposing it. The splinter is then lifted out with the blade or a forceps.

Anesthesia may be spared for removal of a small, superficial splinter. The splinter may be removed by picking it out with an 18-gauge needle, using light feathering strokes to de-roof the skin over the splinter.2 Once the sliver is reached, it can be lifted out with the needle tip or with the aid of small forceps. A firm pinching pressure applied to the local area reduces the amount of pain the patient may feel and controls the bleeding.15

View/Print Figure

FIGURE 2.

Vertical splinter removal. A superficial incision is made over the sliver, followed by deeper incisions, undermining both sides of the wound. The central block of contaminated tissue containing the splinter is then excised with a deep elliptic incision around the wound entrance.


FIGURE 2.

Vertical splinter removal. A superficial incision is made over the sliver, followed by deeper incisions, undermining both sides of the wound. The central block of contaminated tissue containing the splinter is then excised with a deep elliptic incision around the wound entrance.

VERTICAL SPLINTERS

Splinters or foreign bodies such as needles that are at a right angle to the skin surface are usually more painful and difficult to remove. After injection of local anesthesia and a povidone-iodine cleansing, a superficial incision is made over the splinter, followed by deeper incisions around the splinter, undermining both sides of the wound. This maneuver facilitates displacement of the splinter to the middle of the wound, where it is then excised with a deep elliptic incision around the wound entrance (Figure 2).

DEEPER, ELUSIVE SPLINTERS

The search for a deeper, elusive splinter may be difficult. Before searching for an elusive foreign body, the physician should set a time limit for the search, usually 20 to 30 minutes.16 After this time, further effort only increases the chance of tissue damage, and the likelihood of locating the foreign body is minimal. Blind dissection with a curved hemostat is not recommended. Instead, an imaging technique should be used to help localize a deeper splinter.

View/Print Figure

FIGURE 3.

Subungual splinter removal. A V-shaped piece of nail is cut using small, but strong, scissors and is removed using a nail elevator and a forceps. The splinter is grasped and removed, taking particular care not to push the splinter further into the nail bed.


FIGURE 3.

Subungual splinter removal. A V-shaped piece of nail is cut using small, but strong, scissors and is removed using a nail elevator and a forceps. The splinter is grasped and removed, taking particular care not to push the splinter further into the nail bed.

Radiolucent splinters are not visualized on plain radiographs, and CT scanning, MRI, or ultrasonography should be strongly considered. Markers such as needles help in the precise localization of the splinter and facilitate its removal. Once localized, the foreign body is removed with a forceps or a hemostat, avoiding any unnecessary tissue dissection. Deeper splinters, especially those close to important structures such as nerves, tendons, blood vessels, or vital organs, should be referred for surgical removal.

SUBUNGUAL SPLINTERS

The traumatic introduction of wood splinters under the fingernails and toenails is common and frequently associated with severe throbbing pain.17 Most of the splinters are lodged in the distal portion of the nail and their removal does not result in nail dystrophy. However, for a more proximal subungual splinter, caution must be exercised not to disturb the nail matrix because this may result in failure of the nail to grow back normally.

To remove such a splinter, the digit is anesthetized by means of a digital nerve block, and the nail plate overlying the splinter is partially avulsed. This can be accomplished by a variety of methods. Most commonly, a V-shaped piece of nail is cut using small, but strong, scissors. The point of the V is at the proximal tip of the splinter.17 The V-shaped portion of the nail is removed using a nail elevator and a forceps. The splinter is grasped and removed, taking particular care not to push the splinter further into the nail bed (Figure 3).

The nail plate also may be partially avulsed by shaving the nail plate overlying the splinter with a no. 15 blade. This is done by using light strokes with the blade held in a proximal-to-distal direction. This technique gradually creates a U-shaped defect in the nail, exposing the entire length of the splinter18 (Figure 4).

Alternatively, the distal portion of the nail plate may be vaporized with a carbon dioxide laser unit, if that option is available.17

View/Print Figure

FIGURE 4.

Subungual splinter removal. The nail plate overlying the splinter is shaved using a no. 15 blade. Light strokes are used (in a proximal-to-distal direction), creating a U-shaped defect in the nail and exposing the entire length of the splinter.


FIGURE 4.

Subungual splinter removal. The nail plate overlying the splinter is shaved using a no. 15 blade. Light strokes are used (in a proximal-to-distal direction), creating a U-shaped defect in the nail and exposing the entire length of the splinter.

Follow-Up Care

After removal of the splinter, the wound is copiously irrigated under high pressure, and the contaminated tissue is debrided.4 Sutures are avoided if possible, especially with contaminated wounds, where delayed primary closure is preferred. Routine wound-care instructions are given to the patient, and a 48-hour follow-up visit is scheduled as an office visit or a telephone call. After subungual splinter removal, postoperative wound care should include an occlusive dressing and a topical antibiotic.

The need for tetanus prophylaxis is addressed at the time of removal.2 Prophylactic antibiotics are generally not required but may be considered in some cases, depending on the type of splinter material and the appearance of the skin and subcutaneous tissues.

How to remove a splinter: Methods and tips

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Splinters occur when a small, thin fragment of wood or other material punctures the skin and becomes embedded. In most cases, it will be possible to remove the splinter at home. However, anyone attempting this should always wash their hands and any equipment they will use first. If the area becomes infected, it may be necessary to see a doctor.

In this article, we cover simple methods to remove a splinter and explain when a person should seek medical attention.

Use a recommended method to remove splinters safely at home.

It is possible to remove a splinter at home using one of several methods. The best method depends on:

  • the location of the splinter
  • how deep the splinter is
  • the size of the splinter
  • the direction of the splinter

Below are the most common methods for getting rid of a splinter:

Tweezers

Most people with a small, easy-to-access splinter will use tweezers to remove it. Tweezers make it possible to pinch the splinter and pull it out.

This method involves:

  • disinfecting the tweezers with rubbing alcohol
  • pinching the end of the splinter between the tweezer’s arms
  • pulling the splinter out gently and slowly

Tweezers are available for purchase online.

Duct tape

Duct tape is a very strong tape that can help remove a deeper splinter. This method is often painless.

A person can use duct tape to remove a splinter by:

  • cleaning the area thoroughly
  • applying duct tape to the splinter
  • waiting about 30 minutes
  • pulling the tape off

If this method does not work the first time, it is worth trying again.

Duct tape is available for purchase online.

Needle and tweezers

When the splinter has fully punctured the skin, and no part of the material is visible, a person may be able to expose part of it using a needle. Once part of the splinter is exposed, they can then use the tweezers to remove it.

A person can remove a splinter using a needle and tweezers by:

  • disinfecting both the needle and tweezers with rubbing alcohol
  • puncturing the skin with the needle over the part of the splinter closest to the surface
  • pinching the splinter with the tweezers and pulling it out gently and slowly

Use a solution to draw out the splinter

While this method still needs medical testing, some people try soaking the area in a solution in an attempt to draw out a buried splinter.

Some commonly used solutions include:

  • hydrogen peroxide
  • Epsom salt mixed with water
  • baking soda mixed with water
  • lavender oil
  • honey
  • warm water

Using one of these solutions, try removing the splinter by:

  • soaking the splinter in the liquid for a few minutes
  • using a sanitized pair of tweezers to remove the splinter once it has surfaced

However, if a splinter is completely beneath the skin, it is usually best to visit a doctor to have it removed.

It is important for a person to assess their wound before choosing a removal method. Things to look for include:

  • Is part of the splinter sticking out?
  • Where is the splinter located?
  • In which direction is the splinter going?

Before getting started, a person should thoroughly wash their hands with soapy water and sanitize any equipment that they plan to use, such as tweezers. Always clean the wound after removal to help avoid infection.

If available, use a magnifying glass to help see the splinter. It is also possible to use a lamp or bright natural light from a window.

Finally, it is essential never to squeeze or pinch the skin around the splinter. Applying pressure can cause the splinter to break into more pieces or push it further below the surface.

A person should seek medical attention when:

  • there is redness or discoloration around the splinter
  • the area swells
  • the wound is leaking pus
  • the splinter is large
  • the skin is warm to the touch
  • the splinter is near the eye
  • the wound is excessively painful
  • the splinter is stuck deep in the skin

A splinter is a common but painful injury that it is usually easy to treat at home. Before removing a splinter, a person should be sure to follow proper precautions, such as washing their hands and sanitizing any equipment.

A person should ask a medical professional to remove the splinter if it is very large, is positioned near the eye, or appears infected.

Read the article in Spanish.

Finger infection: Types, symptoms, and treatment

A finger infection is a common problem. The hands are an important way for humans to interact with the world around them.

They are more likely to come into contact with infectious bacteria and other germs because of this, which can lead to infection.

A finger infection will usually start out small and grow with time. There are different types of infections, and serious complications can occur if they are left untreated. Prevention is important, as well as knowing when to see a doctor.

There are many different types of infections, each with their own causes and symptoms.

Felon

A felon is an infection at the tip of the finger. The infection takes over the pad of the fingertip and the soft tissue around it.

Cellulitis

Cellulitis is an infection on the surface of the skin. It usually does not involve the deeper levels of tissue on the hand or finger.

Paronychia

Paronychia is an infection of a hangnail on the finger. The tissues on the edges of the finger near the nail root provide the perfect place for bacteria to enter. It is the most common infection of the hand.

Herpetic whitlow

Herpetic whitlow is an infection caused by a virus. The virus usually infects the fingertip and may be confused for a felon because of this.

It can also have similar symptoms to paronychia, but will not respond to antibiotics.

Deep space infection

Deep space infections are infections that involve one or more structures in the hand and fingers that are below the skin. These may be the blood vessels, tendons, or muscles.

Infectious flexor tenosynovitis

Infectious flexor tenosynovitis is a type of deep space infection that involves the structures in the hand rather than just the skin. This particular type affects the tendons and tendon sheaths responsible for flexing and closing the muscles and bones in the hand.

Share on PinterestA puncture wound on the end of the finger may lead to a felon infection.

Infections around the body are most commonly caused by bacteria that infect the finger due to an injury, such as a cut on the finger.

Other possible entry points for bacteria may be animal or insect bites, paper cuts, or puncture wounds.

Herpetic whitlow is the classic exception to this rule, as it is caused by a virus instead of bacteria. Each type of infection has its own specific causes as well.

Felon

A felon infection is usually the result of a puncture wound, such as poking the tip of the finger with a pin.

Staphylococcal and streptococcal organisms are often the source of the infection. The puncture wound allows these bacteria to get into the deeper layers of the skin and multiply, creating the typical symptoms.

Cellulitis

The same bacteria that cause felon infections are also responsible for cellulitis. The bacteria enter the lower layers of the skin through an open wound. The infection may spread to other parts of the hands and fingers via the bloodstream.

Paronychia

This infection is usually caused by the same bacteria that causes felon infections, though, on rare occasions, a fungus can also cause it. It starts when a hangnail or cuticle becomes irritated and leads to an open would that contains bacteria.

The infection may spread to the surrounding area. Picking, biting, or cutting a hangnail may put a person more at risk for developing paronychia.

Herpetic whitlow

Herpes simplex virus I or II is the virus responsible for herpetic whitlow. It is the same virus that causes outbreaks of oral or genital herpes.

People who work with bodily fluids, such as doctors, dentists, and other medical workers, may be more at risk of contracting the infection. It is also possible for someone with herpes to infect their own finger.

Deep space infection

Deep space infections, including infectious flexor tenosynovitis, are usually caused by a deep puncture wound or very deep cut that allows bacteria to reach the deepest tissues in the hand and finger. The structures of the hand are not ready to deal with surface bacteria and provide plenty of potential areas for the bacteria to infect.

Some people, such as people with compromised immune systems or those with diabetes, may be at an increased risk for infections. Individuals who work in hazardous professions may also be more likely to injure themselves, potentially leading to infection.

Most infections will look pink or red and feel tender to the touch.

When a cut on the finger becomes infected, symptoms include:

  • swelling
  • redness
  • increasing pain in the area
  • pus
  • feeling unwell

Each finger infection comes with its own symptoms as well:

Felon

Typical symptoms of a felon include a swollen and painful fingertip. It may be possible to see a pool of pus forming under the skin.

Cellulitis

Symptoms of cellulitis include red skin that is sensitive and warm to the touch. The area may also swell.

The motion of the hands should not be affected. If it is, a deep space infection may be present.

Paronychia

Symptoms of paronychia include redness and swelling next to the fingernail, which will be painful to touch.

Pus may develop under the nail or skin, which may leak out of the wound. The drainage is usually a white-yellow color.

Herpetic whitlow

Whitlows will look like felons, and may additionally cause a burning or itching sensation in the immediate area. The swelling will likely be milder than in a felon.

It is caused by the herpes simplex virus.

A whitlow may cause one or more open wounds in the area that often occur in clusters.

Deep space infection

Common symptoms and signs of deep space infections include pain when moving certain parts of the hand. The area may become red, very sensitive to touch, and spread along the tendon sheath. The center of the infection may have a soft spot, where a collection of pus is forming.

Infectious flexor tenosynovitis

Infectious flexor tenosynovitis is associated with four major signs, which may not all be present at once:

  • the person will first feel pain and tenderness over the tendons in the finger
  • the finger will begin to swell
  • the person may then feel pain when extending or straightening their finger out
  • once the infection has progressed, the finger will be at rest in a slightly flexed or partially bent position

When to see a doctor

It is important to report signs and symptoms of infection to a doctor as soon as possible to avoid serious complications. The doctor will then be able to discuss the best treatment options.

Doctors will diagnose finger infections by thoroughly identifying symptoms and their cause. They will usually ask a series of questions to determine when the infection began and if there is something stuck in the wound.

They may ask also ask more specific questions, such as if a person has a history of biting their nails or if they have the herpes virus. These questions help narrow the possibilities down for a proper diagnosis and treatment.

Infections caused by bacteria will usually be treated with antibiotics and medical care.

Doctors may simply cut and drain a wound. Sometimes they may need to perform surgery to be sure all of the infection is cleared out.

Treatment varies from person to person, and people should always discuss options with a doctor.

Home remedies

Finger infections can become serious and may lead to a loss of a finger or part of the hand. So, home care for most finger infections is limited.

However, a minor infection of the hangnail can be managed at home with proper wound care that includes allowing the wound to drain. The infection may respond to warm water soaks and regular washing as well. If symptoms do not resolve, contact a doctor for treatment.

All other types of finger infection require immediate medical care.

Preventing finger infections begins with basic hygiene and following safety practices when handling dangerous materials or doing dangerous work.

Exposure to bodily fluids should be limited, and regular hand washing can help eliminate germs.

The outlook for most infections that are treated properly and caught early enough is good. If treatment is delayed or infections are severe, there is the possibility for lasting damage.

It is essential to talk with a doctor at the first sign of infection to discuss treatment.

When to DIY and When to Go for Urgent Care

Splinters are perhaps the common cold of injuries. Most people throughout their lifetime will have a few experiences with a foreign object embedded underneath their skin.

Despite a widely believed assumption, splinters are not just the pieces of wood children gets stuck with running their fingers over an old banister. A splinter can refer to the broken glass shard that finds itself lodged in your toe or the plant thorn embedded in your thumb.

And while many incidents of splinters turn out not to be a huge deal and can be removed at home with a good pair of tweezers, there are cases when it’s important for a splinter victim to go for urgent care for some professional assistance.    Keep reading and to learn when splinter removal is okay to do on your own and when it’s imperative you see a physician.

Evaluating the Splinter

Once you know you’ve had a foreign object poke through your skin, or that of your child, it’s important to look for signs of a splinter. Inspect the body for small specks under the skin and redness and swelling around the point of entry. If you see any of these things and of course the feeling of something in the skin is present, then it’s fine to proceed with the splinter removal process.

First, after locating the object, clean the area with some water and mild soap.  Next, you’ll want to sterilize a pair of tweezers or a small needle with some rubbing alcohol.

If part of the splintered object is sticking out of the skin, use the tweezers to gently pull it out the entire splinter.

However, if the splintered object isn’t sticking out of the skin, then you’ll have to open a part of the skin and guide the splinter to the hole with the needle. As the splinter starts to stick out the skin, then grab the object with the tweezers.

The only thing left to do after the splinter is removed is clean the wound, apply an antibiotic ointment, and cover the punctured area of the skin with a bandage.

Now should you be one of those individuals who doesn’t like needles or tweezers, there are other alternative methods you can use. 

When Splinter Removal Is no Longer a DIY Project

In cases where you can’t see the splinter but know there is a foreign object embedded in the skin, you should go to urgent care. If you’re unable to remove the entire splinter from the skin, again, go to urgent care. If it turns out that the foreign object embedded in the skin is causing severe bleeding or an allergic reaction, go to urgent care.

And please be advised, that thorns from certain plants can cause some serious health concerns if they splinter off into the skin.

When it Doubt Get Some Help

On most occasions, splinter removal is something that can happen in the comforts of your own home. However, if a splinter is presenting a more dangerous situation than you can handle, or you’d rather be safe than sorry, make sure you contact us or just come on in.

proposed diagnostic algorithm to detect radiolucent objects

Patient Saf Surg. 2013; 7: 25.

,1,3,1,2,1 and 1

Kyros Ipaktchi

1Department of Orthopaedic Surgery, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

Andrew DeMars

3University of Colorado School of Medicine, Anschutz Campus, Aurora, CO 80045, USA

Jung Park

1Department of Orthopaedic Surgery, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

Christopher Ciarallo

2Department of Anesthesiology, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

Meryl Livermore

1Department of Orthopaedic Surgery, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

Rodrigo Banegas

1Department of Orthopaedic Surgery, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

1Department of Orthopaedic Surgery, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

2Department of Anesthesiology, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

3University of Colorado School of Medicine, Anschutz Campus, Aurora, CO 80045, USA

Corresponding author.

Received 2013 May 24; Accepted 2013 Jul 5.

Copyright © 2013 Ipaktchi et al.; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been cited by other articles in PMC.

Abstract

Background

Penetrating injuries to the hand can compromise important anatomic structures, and persisting foreign objects may become a source of infection. Foreign body intrusions into the hand are among the most common injuries to the upper extremity seen in the Emergency Department. Radiolucent organic objects, as well as a few higher density inorganic materials such as plastic, present a diagnostic challenge and are routinely missed using standard radiography. While the literature describes the use of high-frequency ultrasound as an adjunct to conventional diagnostics, to our knowledge, no formal algorithm has been published.

Case presentation

We describe a case of incomplete wooden splinter removal, presenting as a late midpalmar abscess five months after the initial injury, and requiring two subsequent surgical explorations for definitive treatment. This case has led us to implement a formal diagnostic pathway including high-frequency ultrasound at our institution. We contrast this presentation with a subsequent case involving a much smaller wooden palmar foreign body that was easily identified under ultrasound and removed without sequelae.

Conclusion

Many hand injuries are caused by low density, radiolucent foreign bodies. These objects can easily escape traditional evaluation in the emergency room including standard radiography. We present an algorithm implementing high frequency ultrasound to minimize the risk of missing radiolucent penetrating foreign objects in the hand.

Keywords: Foreign objects, Midpalmar space, Ultrasound

Background

Hand injuries are among the most frequent causes for Emergency Department visits, many of which are due to foreign body intrusion
[1]. The density of important anatomic structures explains the increased rate of complex injuries and long-term morbidity. Standard physical hand examination fails to detect up to 38% of foreign bodies, and routine radiographs identify wooden objects in only 15% of cases
[2,3]. Overall detection of foreign bodies of any material by plain film radiography has been quoted at 80%
[4]. In contrast, high-frequency ultrasound (≥ 7.5 MHz) has been shown to identify foreign bodies with a sensitivity of 87-93% and a specificity of 89-99%
[5]. Failure to detect organic foreign bodies can lead to infection and functional morbidity. Plant thorns are of particular concern since they have low structural density and high radiolucency, and persisting thorns may lead to chronic synovitis
[6].

Case presentation

Case # 1

A 39 year-old right hand dominant male, presented to an outside facility after a large wooden splinter had pierced through the hypothenar eminence of his non-dominant hand and had broken off. Per report, a splinter was removed and plain film radiography was unremarkable. However, despite the procedure, the patient reported a persisting density in his palm. Eight weeks later, the patient presented to our Emergency Department complaining of a “popping” sensation, palmar erythema and swelling in the affected hand. Clinically, the hand was neurovascular intact, with intact tendon function. Forced passive extension was painful in the palm and there was obvious local swelling. The patient had a mild leukocytosis, while C-reactive protein and sedimentation rates were normal. Plain film radiographs were unremarkable except for a well-healed fifth metacarpal fracture and the presence of palmar soft tissue swelling.

The patient was taken to the operating room for irrigation and debridement. Exploration of his palm revealed no foreign body or purulence. However, there was inflammation involving the flexor tendon sheath. After an uneventful recovery, the patient regained full finger function and resumed work. Three months later, the patient returned to the Emergency Department with a fluctuant abscess in the affected palm (Figure 
). Surgical exploration at that time showed a large epifascial abscess, which originated in the mid-palmar space and had spread superficially (Figure 
). Further deep exploration revealed, surprisingly, a retained one-inch long wooden splinter (Figure 
). The deep location of the splinter below the flexor tendons in the midpalmar space may have contributed to the failed detection of this object during the first exploration (Figure 
). Subsequent recovery after removal of the foreign body was uneventful.

Intraoperative photo showing a deep palmar abscess. Five months after incomplete wooden splinter removal the patient is readmitted for surgical exploration. Fingers are held in protective flexion position due to compartmental swelling of the deep palmar space.

Opened deep palmar space. Surgical exploration of the mid-palmar space abscess which had decompressed through the flexor tendons and palmar aponeurosis.

Retrieved radiolucent oneinch long wooden splinter. The operation yielded the surprising finding of a near 1 inch long wooden splinter which had resided for 5 months undetected in the deep palmar space.

Drawing of the midpalmar crossectional anatomy. Green colored thenar and mid-palmar spaces demonstrating the relative depth of these enclosed compartments which can be sites of infection. The location of the removed wooden splinter is depicted in blue.

Case # 2

A 46 year-old carpenter had sustained a wooden splinter injury six months before presenting in hand clinic with tenderness in the first webspace. There were no signs of infection on clinical exam and plain film radiographs were negative. Our new foreign body diagnostic pathway was implemented and the high-frequency ultrasound examination revealed a 2.7 mm foreign object in the first webspace (Figures 
and
). Subsequent surgical exploration revealed a retained wooden splinter, and the patient had an uneventful recovery.

Proposed diagnostic algorithm to enhance the detection of radiolucent foreign objects in the hand. This algorithm details the use of high frequency ultrasound in the Emergency room as well as in the operative suite.

High frequency linear ultrasound image. Ultrasound detection of a 2.7 mm wooden splinter in the first webspace distance measurement in between the 2 tracking cross marks. This demonstrates the resolution of current ultrasound probes which would have allowed for easy detection of the nearly 3 cm or 1 inch long splinter shown in Figure
.

Discussion

Common low-density organic materials – such as thorns, wood and fish bones – along with some higher density inorganic materials – such as glass and plastic – account for a large percentage of hand foreign bodies. Historically, soft tissue radiography has been described as a useful diagnostic adjunct for foreign body localization
[7]. However, as radiodensity is a consequence of both material density and atomic number, wood is consistently elusive on plain film radiography
[2].

Soon after its clinical introduction, computerized tomography (CT) was found to be a highly useful modality to detect deep and embedded low density objects
[8]. Although computerized tomography is readily available in most hospitals, it is typically not performed as a dynamic study, and the exposure to ionizing radiation is significant. Magnetic resonance imaging (MRI) has also been advocated for soft tissue foreign body localization. However, there are significant financial costs and long acquisition times, and extremity MRI protocols are frequently limited to two millimeter section intervals. Additionally, magnetic resonance imaging may produce an unacceptable number of false-positive diagnoses, as structures such as scar tissue, tendons and calcifications may be mistaken for foreign bodies
[9].

Ultrasound has been used for foreign body localization since 1978
[10]. While the ultimate resolution limit of a 10 MHz sound wave in tissue is approximately 0.15 mm, practical application of high-frequency ultrasound has identified foreign objects as small as 0.5 mm and as deep as 4 cm
[3]. The use of ultrasound conducting gel as a standoff pad or immersing the extremity in a water bath during visualization have both been described to improve the detection of superficial foreign bodies and to minimize patient discomfort from direct transducer pressure
[11]. Dynamic ultrasound scanning should be performed, and the tissue should be imaged in two planes in an axis perpendicular to the surface of the suspected foreign body.

Most foreign bodies are hyperechoic, and the induced inflammatory changes appear as a surrounding hypoechoic rim, beginning within twenty-four hours of intrusion
[5]. Metal and glass may cause a “comet tail” artifact, while gravel demonstrates strong posterior acoustic shadowing
[11]. Power Doppler may be used to identify acute inflammatory changes and neogranulation around foreign bodies, but it may not be positive for up to two days after intrusion
[12]. Limitations to ultrasound detection of soft tissue foreign bodies include gas bubbles, hematomas, calcified soft tissues and operator inexperience. While some authors have argued that high-frequency ultrasound should be the imaging modality of choice for foreign body localization, others have suggested that ultrasound should replace conventional fluoroscopy for preoperative localization
[3].

Conclusion

Many hand injuries are caused by low density, radiolucent foreign bodies. Superficial foreign bodies can frequently be localized during physical examination and removed without difficulty. However, radiolucent objects, particularly those that are smaller and deeper, may not be identified on plain film radiographs or even during superficial surgical exploration. As compared to other soft tissue imaging modalities such as CT and MRI, high-frequency ultrasound appears to be an equally efficacious, more cost-effective, and readily available option in most Emergency Departments. Additionally, high-frequency ultrasound allows for a dynamic, real-time intervention with concurrent evaluation of adjacent soft tissues. With the intent to optimize foreign body detection, minimize cost and reduce exposure to ionizing radiation, we present a formal diagnostic algorithm that includes ultrasound to evaluate suspected hand foreign bodies.

Consent

Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Abbreviations

MHz: Megahertz; Mm: Millimeter; CT: Computerized tomography; MRI: Magnetic resonance imaging; US: Ultrasound

Competing interests

The authors declare that they have no competing interests.

Authors’ contribution

KI provided the case and idea and prepared the manuscript, AD and JP reviewed the manuscript, CC reviewed of manuscript and provided the ultrasound content and designed Figure
together with KI; RB reviewed the manuscript and drew Figure
, ML reviewed the manuscript. All authors read and approved the final manuscript.

References

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90,000 Cracked protective glass on a smartphone almost cost a man a finger

23-year-old Malaysian Azwan Iqbal Abdullah Sani almost lost his thumb due to his unwillingness to replace the protective glass on his smartphone, which cracked four months before the incident.Despite this, the man continued to actively use the gadget, including playing a lot on it.

One “fine” day Azwan noticed that his right thumb was swollen, began to hurt and strange black spots appeared on it. The man went to the doctor. He diagnosed a bacterial infection and prescribed antibiotics and pain relievers. Azwan began taking medication, but the finger swelled more and more, and the pain only intensified.

Then the Malaysian turned to another doctor.This time, the medic discovered that the trouble was not only the infection, but also what caused it. As it turned out, microscopic fragments of cracked protective glass penetrated under the skin. Without their removal, no antibiotics could help the would-be amateur to play on the smartphone. The man was sent for an urgent operation, as delay was fraught with amputation. The operation was successful and the finger has already begun to heal.

Source: Asia One
Photo: pixabay.com

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90,000 Treatment of wounds in a child – blog of the ON Clinic medical center

What to do if a child has a wound, how to treat it and when to go to the doctor – we will tell you in this article.

Childhood is a time of curiosity, accompanied by injuries, falls, abrasions and wounds. Some of the wounds are harmless and require routine home treatment, while others require serious treatment.

What are the types of wounds

A wound is tissue damage that is characterized by a violation of the integrity of the skin or mucous membranes. The wound is accompanied by pain and bleeding.

The first sign is pain. It occurs due to damage to local nerve endings, later due to edema, which presses on the nerve and irritates it.In this case, pain can spread not only along the surface of the wound, but also along the damaged nerve.

The second mandatory sign of a wound is bleeding. It occurs as a result of damage to capillaries, veins, or arteries. Bleeding can be mild and drip, for example, with a small cut, and severe when the integrity of the vein and artery is damaged.

The third sign of a wound is a gaping. However, gaping appears only with deep wounds, for example, with abrasions it is not. Gaping – the divergence of the edges of the wound on the sides of the axis of the cut.With severe dehiscence, the wound is usually sutured.

There are many types of wounds. For a person in a domestic environment, it is necessary to know several classifications. The first is based on whether there is an infection in the wound. Wounds can be aseptic, contaminated, and infected.

Aseptic wound is a clean injury to the skin. Usually, these are surgical wounds that are performed in order to penetrate the internal organs. Children most often have contaminated wounds.This means that microbes have entered the area of ​​skin damage. At first, these are relatively harmless wounds: local defense mechanisms inhibit the development of microorganisms. If you do not treat a contaminated wound, it becomes infected: an infectious process develops, which is accompanied by inflammation, severe pain and suppuration. An infected wound can cause a strong reaction in the child’s body: the body temperature rises, chills, drowsiness and apathy appear.

By the nature of the damage, there are the following wounds:

  • stabs – they occur when punctured by a narrow and stabbing object, for example, when a child falls on a nail.The puncture wound usually bleeds mildly and hurts. Outwardly, it may seem that this is a safe wound, but it is not: often large vessels, nerves are damaged, and even an infection is brought in;
  • cut – occur on contact with a sharp oblong object: a knife, razor, sharp scissors, glass shard and paper. With a cut wound, tissue is usually slightly damaged. The wound bleeds badly, pains moderately;
  • Chopped wounds are caused by a heavy sharp object such as an ax.Usually the bleeding is moderate, but the wound is very sore and gaping. May lead to serious condition;
  • A bruised wound appears when struck with a blunt object or falling on the asphalt. Most often, the bruised wound is located on the head, elbows and knees. The edges of the wound when bruised are uneven, soaked in blood. Bleeds slightly and pains moderately.

There are also bite wounds that occur when bitten by animals or other children. The difficulty with this wound is that in most cases it contains an infection from the animal’s mouth.Thus, rabies, insect and snake venom, putrefactive infection are transmitted.

The wound process consists of several stages:

  1. In the first seconds after skin damage, local vessels reflexively narrow and biologically active substances are produced – platelets, which adhere to the wound area and close the damaged vessel. The blood clotting system turns on, which stops bleeding. In a healthy child, bleeding stops on its own within 15 minutes.
  2. Inflammation. Lasts 3 days from the moment of injury. The inflammation is manifested by pain, redness, and localized fever. Also, swelling in the form of a tumor appears on the wound within two hours.
  3. After 2–4 hours after injury, leukocytes migrate to the damaged area. They absorb foreign particles and cleanse the wound of microorganisms.
  4. Healing phase. Begins 3-5 days after injury. Bioactive substances arrive at the damaged tissues, which restore the tissue of blood vessels and skin.
  5. Epithelialization phase. Begins 2 weeks after injury. The wound mark becomes pale, a scar is formed. The epithelialization phase can be delayed if bacteria are present in the wound.

Algorithm for treating wounds

What to do if a child has fallen, cut or hit:

  1. Make sure you are safe: you drive the dog away, remove the knife, turn off the chainsaw, remove the broken glass.
  2. Usually, in a situation of injury, the child is frightened: by pain or the fact of a cut.Calm him down and tell him that nothing terrible happened. Make him feel protected.
  3. Before handling a wound, wash your hands first with soap and water.
  4. Remove clothing from the injured area: roll up the sleeve of your shirt, lift your shirt or trouser leg. Examine the wound. Try not to touch the wound with dirty hands.
  5. If the capillaries are damaged, the bleeding is insignificant. Rinse the wound with warm water, apply hydrogen peroxide and bandage with a gauze bandage.
  6. Gently clean debris and debris from the wound under warm water.To do this, use cotton swabs or gauze soaked in disinfectant.
  7. Disinfect the wound. Usually at home there is always an alcoholic solution of iodine, cologne, hydrogen peroxide, alcohol or spirits. Dilute the alcohol with water so as not to burn the wound. If the wound is large, alcohol and iodine cannot be used, they will lead to chemical burns and the wound will heal more slowly.
  8. Apply sterile material to wound and bandage. You need to bandage so that the bandage covers the wound site.It shouldn’t be too tight or too soft.

What to do if your child is bleeding heavily:

  1. Assess the severity of the bleeding. If the wound bleeds heavily with dark or scarlet blood, beats with a stream, and the ejection of blood is synchronous with the heartbeats, the bleeding must be stopped at all costs.
  2. Call an ambulance. One person provides first aid, the second calls the team. Please note that if the wound is penetrating, that is, a screwdriver or knife is stuck into the body, you cannot remove the object yourself.Be sure to wait for an ambulance.
  3. Find a tissue or other tissue in your bag or medicine cabinet that you can apply to the wound.
  4. If the limb is injured, lay the child on his back and lift the injured limb above the level of the heart, bend them at the elbow or knee. This is temporarily uncomfortable, but slows down the blood flow.
  5. Apply harness. If not, use a belt, tie, brace, or wire. You need to put a napkin or cloth under the tourniquet so as not to injure the skin.For arterial bleeding, a tourniquet is applied above the wound site; for venous bleeding, a pressure bandage is applied to the wound. Mark the time of application of the tourniquet, write it down with a pen or felt-tip pen (but not red) on the skin near the tourniquet. Remember that in summer the maximum application time of the tourniquet is 90 minutes, in winter – 60 minutes. If after this time the ambulance has not arrived, and you have not yet reached the hospital, carefully loosen the tourniquet so that the tissues of the limb receive blood, while pressing the bleeding site with gauze.If the dressing is soaked in blood, re-clamp the tourniquet until the blood stops completely and record the new time on the skin.

It is not recommended to give your child pain relievers. This interferes with the fact that each drug has an expiration date and doctors need to recalculate the dose of a new pain reliever or wait for the previous one to end in order to avoid an overdose. But if pain relief is indispensable, write down the time and name of the drug you gave your child. Save empty vials of medication and give them to the ambulance team so they know what you gave to the victim.

Treatment of abrasions in children

How to properly treat abrasions in children:

  1. Wash your hands.
  2. Clean any dirt, dust, debris and other objects around the wound.
  3. Disinfect the wound: the abrasion can be treated with the following means: ointment with zinc oxide, cream with benzalkonium chloride, cream with dexpanthenol, chlorhexidine, methyl blue, hydrogen peroxide, brilliant green and 5% iodine solution.
  4. Usually mild capillary bleeding occurs with abrasions.It is enough to apply a dry cloth or gauze to the damaged skin.

What to do if the wound does not heal for a long time

The wound may not heal for a long time. This is due to several factors: the skin after injury is not cleaned, blood flow is complicated due to inflammation, or the regeneration mechanism is impaired. Because of this, complications arise:

  • seroma is an accumulation of inflammatory fluid (exudate) in the wound cavity. Most often, seromas occur if dirt, microorganisms or foreign bodies remain in the wound;
  • Wound hematoma.It appears due to the fact that after the injury, the bleeding did not stop completely, and the drops of blood gradually soaked the surrounding tissue. Also, hematomas occur due to diseases in which blood clotting is impaired;
  • Soft tissue necrosis. It occurs due to severe and massive tissue damage or cutting of blood vessels. Early signs of necrosis: in the first days after injury, the skin is pale, bluish and cold to the touch;
  • Malignancy is a process when cells in a tissue acquire the characteristics of a tumor.Malignancy occurs with a chronically non-healing wound.

In addition, the wound may not heal for a long time with poor immunity, diabetes mellitus, long-term intake of glucocorticoids and vitamin deficiency. The only correct option is to consult a surgeon: at home it is impossible to assess the condition of the wound and provide the correct medical care.

When to see a doctor

To protect your child from complications, you need to know in what situations to see a doctor:

  • if after 15 minutes the wound has not stopped bleeding even when applying a pressure bandage;
  • if outside the wound the skin begins to grow numb, cool, acquire a pale or bluish tint;
  • if you are not sure that the wound is completely cleaned of debris, rust, dirt and other foreign objects;
  • if the injury occurred in the neck;
  • if the child was bitten by an animal;
  • The wound does not heal within 10 days.

Alarming signs also include: an increase in the child’s body temperature, an increase in edema, increased pain, a burning sensation and severe reddening of the wound.

A wound is tissue damage that needs first aid. However, if you treat the wound according to the algorithm, after 10-15 minutes the blood stops, and by the end of the day or the next day, the pain goes away. The main thing when a child is injured is not to succumb to emotions, calm the child, act quickly and call an ambulance or see a doctor.

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90,000 appointments, prices in the center of traumatology and orthopedics Miracle Doctor

“Miracle Doctor” is one of the few clinics in Moscow, where you will be offered not only conservative, but also surgical treatment of diseases of the musculoskeletal system. In addition, we admit patients with acute injuries and pains of unknown origin.Experienced traumatologists-orthopedists conduct receptions in the center, who, if necessary, are ready to go to your house.

“Miracle Doctor” is a clinic that provides medical care in accordance with the highest international standards. Thanks to the use of the latest scientific achievements, competent treatment of patients with injuries and diseases of the joints and spine is carried out, and subsequent rehabilitation does not take much time. In a superbly equipped hospital, our doctors see up to 20 patients every day.And the most comfortable stay is ensured by the attentive, caring attitude of the staff. In addition to the round-the-clock hospital, the clinic is also staffed with an intensive care team.

Why should you contact the Miracle Doctor Traumatology and Orthopedics Center?

Throughout the year, we carry out a large number of operations using advanced technologies and modern equipment. Traumatology and orthopedics are two closely related areas of medicine. We are engaged in carrying out emergency, urgent operations, performing planned surgical interventions in patients with the most severe injuries and diseases of the musculoskeletal system.In the department of aesthetic surgery, they have been successfully increasing their height for a long time, correcting the curvature of the legs.

Our elderly patients recover quickly through special geriatric programs. Operations, conservative treatment and rehabilitation are also performed using copyright programs. The clinic “Miracle Doctor” uses the most modern physiotherapeutic methods, chiropractors, doctors specializing in reflexology work here.

Qualified doctors

The general practical experience of some orthopedic traumatologists exceeds 30 years.Reception is conducted by doctors of the highest category and Ph.D.

Multidisciplinary team

If necessary, physiotherapists, neurologists, chiropractors will start working with the patient

Modern equipment

We carry out a comprehensive examination of patients with injuries, including X-ray, ultrasound diagnostics and much more

Effective treatment

We use advanced minimally invasive surgical techniques for treating injuries and diseases of the osteoarticular apparatus

Comfortable hospital

Treatment and rehabilitation measures are carried out with the accommodation of patients in cozy rooms with all the amenities

Service for demanding patients

We accept patients without breaks and days off, provide psychological support during the treatment period

Traumatology and Orthopedics

Not a single person is insured against household, industrial or sports injuries in the form of cuts, burns, electric shocks, bone fractures, joint dislocations, sprains, bruises, etc.In each of these cases, you cannot do without specialized medical services.

An orthopedic traumatologist is a doctor who provides emergency care to patients with injuries, as well as diagnoses, treats and prevents chronic diseases of the musculoskeletal system. This area of ​​medicine is closely related to hematology, oncology, rheumatology, neurosurgery, vascular, septic and burn surgery.

What is the difference between traumatology and orthopedics? The first area of ​​medicine considers diseases of the musculoskeletal system resulting from physical damage (trauma) and their consequences.The second is associated with the diagnosis and treatment of various organic (degenerative and age-related) diseases of the musculoskeletal system, such as bursitis, tendonitis, synovitis, arthrosis, ankylosis, etc.

When is it necessary to make an appointment with a traumatologist?

The reason for going to the doctor should be:

  • visible deformities of the arms, legs, spine;
  • pain that occurs with a deep breath;
  • limitation of joint mobility;
  • crunch and clicks when moving;
  • pain, redness, bruising in soft tissues;
  • joint instability, swelling and increase in volume;
  • 90,046 posture disorders;

  • Feeling of numbness in the hands and fingers;
  • any injuries, even insignificant at first glance;
  • animal bites, accompanied by a violation of the integrity of soft tissues, abrasions, bleeding, etc.;

In addition, pain at the site of old fractures, dislocations or sprains, as well as congenital deformities of the musculoskeletal system, should become a reason for contacting an orthopedic traumatologist. The Miracle Doctor medical center employs specialists who accept adults and children. The sooner you seek help, the more successful your treatment will be.

How is an appointment with a traumatologist going?

Despite the fact that many conditions and pathologies require emergency care, we recommend that you give advance notice of your visit so that we can prepare.A scheduled paid appointment with an orthopedic traumatologist is carried out by appointment.

one

Appointment

Medical center “Miracle Doctor” works seven days a week, you can visit a doctor at any convenient time. An appointment with a traumatologist is made by phone in Moscow, indicated in the heading of the site, or through the web form on the site.

2

Diagnostics

Consultation with an orthopedic traumatologist includes a detailed conversation with the patient, an analysis of his complaints, a visual assessment of the condition of the skin, muscles and ligaments, a check of the range of motion, taking into account the state of health.In addition, laboratory and instrumental studies are carried out.

3

Treatment

The doctor draws up a therapy regimen based on the results of examinations. Depending on the diagnosis, this can be conservative or surgical treatment. The selected methods are aimed at improving the patient’s quality of life, restoring the functions of the articular-ligamentous apparatus.

Methods for diagnosing injuries and orthopedic diseases

Laboratory tests.They are carried out without fail with an increase in body temperature, the appearance of swelling of the joints and suppuration of wounds. The doctor may prescribe general and biochemical blood tests, which reflect the presence of inflammatory processes in the body.

Radiography. One of the main methods for diagnosing bone fractures, which allows you to see displacements, the presence of fragments and other complications. An orthopedic traumatologist also prescribes X-rays for suspected arthritis, arthrosis, cysts and other joint pathologies.

CT scan. It is carried out to obtain the most complete information about the condition of the joint capsules and bone structures. CT is a layer-by-layer X-ray examination of bones, thanks to which the doctor will be able to determine the localization of pathology with high accuracy.

MRI. Trauma doctors resort to magnetic resonance imaging if they suspect latent injuries, as well as inflammatory, degenerative and neoplastic diseases.MRI is one of the safest and most informative examination methods.

Ultrasound. It is prescribed mainly for examining soft tissues and joints. Ultrasound diagnostics does not carry radiation load on the body and allows you to visualize well all the structural features of the articular bag, which is not always possible with X-ray.

Puncture of the joints. The procedure involves puncturing the joint capsule with a special thin needle for collecting exudate, followed by laboratory examination.The analysis can show the content of blood cells, protein, pathogenic microorganisms, etc. in the fluid.

Arthroscopy. An orthopedic traumatologist performs the procedure using special equipment – an arthroscope, which is inserted into the joint cavity through a micro-puncture. Arthroscopy is prescribed for the diagnosis and treatment of pathologies such as osteochondritis, synovitis, arthrofibrosis, etc.

The gold standard for the diagnosis of injuries and diseases of the musculoskeletal system – arthroscopy.This is a method by which it is possible to make the correct diagnosis in almost 100% of cases. It is with arthroscopy that other diagnostic procedures are compared to assess their accuracy. For example, by conducting magnetic resonance therapy, it is possible to identify 92% of intra-articular injuries. And ultrasound is informative only in 42–45 cases out of 100.

Arthroscopy is a diagnostic and therapeutic technique based on the introduction of endoscopic instruments through miniature skin punctures (0.4–0.5 cm).One of them is required for a video camera that transmits an image to a monitor. So the surgeon controls the course of the operation, and if necessary, quickly corrects it. Instruments are inserted directly into the remaining puncture (or punctures). The size of the largest of them is rarely more than 0.5 cm. The miniature size of the instruments explains the low trauma of diagnostics or surgery.

Arthroscopy is a modern minimally invasive technique that is actively developing and improving. And this is despite the fact that its capabilities were talked about in the scientific world more than 30 years ago.

The benefits of arthroscopy are fundamental:

  • a full examination of the internal articular surface, which is impossible with open operations;
  • low trauma, which explains the quick rehabilitation;
  • no cosmetic defects;
  • stay in stationary conditions for no more than 1-2 days;
  • no need for a plaster cast.

The list of indications for arthroscopy includes:

  • joint instability, including those leading to habitual dislocations;
  • injuries of the ligamentous-tendon apparatus, menisci, cartilaginous structures;
  • chronic bursitis;
  • chronic pain syndrome;
  • impingement syndrome;
  • the presence of freely moving bodies in the articular cavity.

Injuries and diseases treated by an orthopedic traumatologist

Fractures

Any bone damage requires specialized treatment. If, after a blow, fall or other impact, the limb has lost its mobility, became deformed, began to hurt badly, then you need to immediately contact the emergency room. First, an orthopedic traumatologist will direct the patient to an x-ray to determine the nature of the fracture, and then apply a plaster or plastic bandage or orthosis.

Tears and sprains of ligaments and muscles

Such injuries can occur during unsuccessful falls, during sports training and in many other cases. They are characterized by severe pain, limited mobility and joint swelling. Traumatologists-orthopedists of the Miracle Doctor clinic use kinesio taping and other modern methods of treatment. The result is a quick relief of pain syndrome and the return of muscle and ligament functionality.

Dislocations

Trauma is a complete displacement of the articular ends of the bones relative to each other. Active movements become impossible. In this case, the traumatologist anesthetizes the joint, adjusts the dislocation and applies a fixing bandage. In the future, the patient may require a course of physiotherapy, manual or osteopathic treatment.

Posture disorders

The most common forms of curvature of the spine are scoliosis, kyphosis, and lordosis.The Miracle Doctor medical center provides comprehensive treatment for all possible types of posture disorders. For this, specialists use the most effective methods for correcting the location of the vertebrae: exercise therapy, thoracolumbar correctors, massage, manual therapy, acupuncture, magnetotherapy, etc.

Osteochondrosis

This is a common disorder of the spine in which the intervertebral discs lose their ability to function properly and to provide supportive and shock-absorbing functions.The most effective is an integrated approach to the treatment of osteochondrosis. In addition to the traumatologist, other doctors work with the patient: therapist, neuropathologist, physiotherapist, chiropractor, osteopath.

Flat feet, heel spurs

Foot pathologies affect the entire human musculoskeletal system. In particular, flat feet can lead to impaired amortization function and the development of diseases of the spine.The Miracle Doctor center uses conservative methods to correct this problem. We offer a course of massage, exercise therapy, physiotherapy. Heel spurs are treated with medicinal and surgical methods.

Deforming arthrosis

The disease is characterized by progressive destruction of cartilage tissue on the articular surfaces. What does an orthopedist treat in this case? The specialist is faced with the complex task of restoring normal blood circulation to the joint, eliminating its excessive mobility and other traumatic factors, and stimulating the regenerative processes of cartilage tissue.

Rheumatoid arthritis

It is an inflammatory disease in which symmetrical joint damage occurs. In some cases, the pathological process affects the internal organs. It is recommended that a patient with rheumatoid arthritis regularly make an appointment with an orthopedist and undergo complex treatment, including taking basic, anti-inflammatory, hormonal and other drugs, as well as physiotherapy.

Tendobursitis

The disease affects the tendons and causes inflammation of the bursa, which is accompanied by the abundant formation of exudate.Tenobursitis is manifested by pain, swelling, high fever, and general weakness. An orthopedic traumatologist is also involved in the treatment of various manifestations of inflammatory joint pathologies. In some cases, the patient may require surgery.

Tumor pathologies of the joints

Benign and malignant neoplasms in bone tissues are considered one of the most difficult and dangerous, since in many cases they are asymptomatic and are diagnosed at later stages.At the same time, modern methods of treatment, including radiation and chemotherapy, have shown high efficiency in the fight against tumors. Specialists of the Miracle Doctor center see patients with oncology.

Methods for the treatment of diseases of the musculoskeletal system

Modern traumatology and orthopedics are the latest drugs and materials for first aid, advanced manual, physiotherapy and surgical techniques. The traumatologists of our clinic have all the possibilities that this area of ​​medicine can offer.

Each patient who comes to us is treated according to an effective and safe individual plan. Currently, the Miracle Doctor clinic is a private medical center with high-tech facilities for high-quality conservative and surgical treatment of people with injuries, joint and spinal pathologies of any severity.

In the clinic, injuries of the musculoskeletal system, acute and chronic diseases are diagnosed with high accuracy.Fast and painless diagnosis is due to computed and magnetic resonance imaging, digital radiography, ultrasound and laboratory examinations.

Thanks to advanced surgical techniques and highly qualified practitioners, the patient is guaranteed effective treatment aimed at restoring the optimal range of motion without cosmetic defects.

We work in order to provide patients with qualified medical assistance at any time of the day in case of injury to the musculoskeletal system or any disease affecting it.We will do our best to ensure that the treatment gives the most positive result, and the rehabilitation is short. After discharge, the patient can quickly return to an active lifestyle, including sports training.

The choice of the method of therapy depends on the diagnosis and the characteristics of the injury or disease.

Conservative therapy. An orthopedic traumatologist can prescribe a patient to take anti-inflammatory, analgesic, immunostimulating and other drugs.Wound healing and antibacterial ointments can be used to treat soft tissue injuries. For joint diseases, the drug can be injected directly into the synovial bag using injections. In addition, medical compresses are widely used.

Physiotherapy procedures. For chronic diseases of the articular-ligamentous apparatus, treatment of fractures and other injuries, the doctor may prescribe massage, acupuncture, as well as laser, ultrasound, ultraviolet and other types of physiotherapy.As a rule, such procedures are carried out outside the stage of exacerbation of the disease. Their goal is to eliminate chronic pain syndrome and swelling, tone muscles, and restore normal blood circulation.

Orthotics. This direction involves the use of technical means of rehabilitation: corsets, orthoses, reclinators, head holders, orthopedic shoes, etc. The products are designed to fix joints, give them immobility during the recovery period, as well as for other purposes: muscle relaxation, functional correction of limbs, etc.Many medical devices are tailor-made for each patient.

Surgery. It involves the treatment of wounds, their drainage and suturing, anesthetic novocaine blockades for fractures or diseases such as osteochondrosis, elimination of bone displacement during fracture, reduction of dislocations, removal of neoplasms and much more. All manipulations are performed by a qualified trauma surgeon.

In case of injury or symptoms of diseases of the musculoskeletal system, immediately contact the emergency room of the Miracle Doctor medical center! Here you will be provided with qualified assistance and will do everything for a speedy recovery.

To make an appointment for a paid appointment with an orthopedic traumatologist, call the phone number listed in the website header, or fill out the online form on the website.

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