Splinter in finger swollen. Swollen Finger with Splinter: Diagnosis, Treatment, and Prevention
What causes a swollen finger after removing a splinter? How do you properly treat a finger felon? Get answers to these questions and more in this comprehensive guide.
Diagnosing the Swollen Finger
When an 18-year-old male presents with a painful and swollen left thumb after removing a splinter a few days prior, the most likely diagnosis is a felon. A felon is a subcutaneous abscess that develops in the finger pulp, most commonly affecting the thumb or index finger. The key distinguishing factor between a felon and other hand infections is the location of the swelling, which in a felon does not extend past the distal interphalangeal joint.
Understanding the Mechanism of a Felon
A felon typically develops secondary to penetration by a foreign body, minor trauma such as biting the fingernail, or local spread from a paronychia (nail fold infection). The infection occurs in the microcompartments of the finger, and the resulting swelling can be severe enough to cause compartment syndrome. It is important to differentiate a felon from the more serious condition of flexor tenosynovitis, which involves infection of the flexor tendon sheath and requires prompt treatment to prevent complications.
Distinguishing a Felon from Other Hand Infections
The main diagnostic clue to differentiate a felon from flexor tenosynovitis is the location of the swelling. In a felon, the swelling is confined to the finger pulp and does not extend past the distal interphalangeal joint. If the swelling does extend proximally, there is a concern for the infection spreading into the flexor tendon sheath, which requires immediate antibiotic treatment and orthopedic consultation.
Managing a Felon
The initial management of a felon can include warm compresses and supportive care. However, the definitive treatment is incision and drainage. The incision should be made on the ulnar side for digits 2-4 and the radial side for the thumb and 5th digit, distal to the distal interphalangeal joint. A digital block should be considered to provide adequate analgesia during the procedure. The use of antibiotics after drainage is controversial, but if prescribed, should cover Staphylococcus aureus, the most common causative organism.
Preventing Finger Infections
To prevent finger infections like a felon, it is important to properly care for any puncture wounds or splinters. Immediately clean the area, remove any visible foreign material, and monitor for signs of infection such as increased pain, swelling, redness, or drainage. Seeking medical attention for any concerning finger injuries or infections is crucial to prevent complications.
Key Takeaways
- A felon is a subcutaneous abscess in the finger pulp, most commonly affecting the thumb or index finger.
- Felons typically develop due to penetration by a foreign body, minor trauma, or local spread from a paronychia.
- To distinguish a felon from flexor tenosynovitis, the key is the location of the swelling – a felon does not extend past the distal interphalangeal joint.
- The definitive treatment for a felon is incision and drainage, with the incision made on the appropriate side of the finger.
- Proper wound care and prompt medical attention for any finger injuries or infections can help prevent the development of a felon or other serious hand infections.
Frequently Asked Questions
What is the most common organism causing a felon?
The most common organism leading to a felon is Staphylococcus aureus.
How does a felon differ from a paronychia?
A felon is a subcutaneous abscess in the finger pulp, while a paronychia is an infection in the epidermis along the nail fold. The location of the swelling is the key distinguishing factor.
When should I seek medical attention for a finger injury or infection?
It is important to seek medical attention for any concerning finger injuries or infections, such as those that are painful, swollen, red, or draining, to prevent the development of serious complications like a felon or flexor tenosynovitis.
What is the proper way to remove a deeply embedded splinter?
For deeply embedded splinters that are difficult to grasp with tweezers, using baking soda as a natural exfoliating agent can help bring the splinter closer to the skin’s surface for easier removal.
How do you perform an incision and drainage for a felon?
The incision for a felon should be made distal to the distal interphalangeal joint, on the ulnar side for digits 2-4 and the radial side for the thumb and 5th digit. A digital block should be used to provide adequate anesthesia during the procedure.
When should I suspect flexor tenosynovitis instead of a felon?
If the swelling extends proximal to the distal interphalangeal joint, there is a concern for the infection spreading into the flexor tendon sheath, which requires immediate antibiotic treatment and orthopedic consultation to prevent complications.
What is the role of antibiotics in the management of a felon?
The use of antibiotics after drainage of a felon is controversial, but if prescribed, they should cover Staphylococcus aureus, the most common causative organism.
Case of the Swollen Finger
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An 18-year-old male presents with a painful and swollen left thumb. He removed a splinter from his finger a few days ago however, 2 days after removal, he began to experience edema and pain that has progressively gotten worse. An image of his finger is shown above (Image 1. Picture courtesy of Rosh Review [1]).
What is your diagnosis?
The patient has a felon. A felon is a subcutaneous abscess in the finger pulp. The most common location for a felon is the thumb or index finger [2-5].
- Pearl: The most common organism leading to a felon is Staph aureus.
How does this condition develop?
The mechanism for the development of a felon can occur secondary to penetration from a foreign body, minor trauma from biting the fingernail, local spread from a paronychia, or idiopathic. There are microcompartments in the finger and when infection arises, the swelling can be severe enough to cause compartment syndrome [2-5].
- Pearl: A felon differs from a paronychia as a felon is in the pulp and usually presents on the pad of the finger while a paronychia is in the epidermis along the nail fold [2,5].
What do you need to rule out? What are other diagnoses that should be considered in the Emergency Department?
Flexor tenosynovitis! This is potentially a finger and/or hand-threatening infection. The location of swelling can differentiate between flexor tenosynovitis and a felon. The swelling in a felon does not extend proximal past the distal interphalangeal joint [4,5]. If it does, there is concern that the infection has spread into the flexor sheath and IV antibiotics and emergent ortho consultation are necessary.
- Pearl: TO identity flexor tenosynovitis utilize the Kanavel signs [4,5].
What is your management?
The management of a felon is similar to that of an abscess. Initial management can include warm compresses and supportive care. The definitive treatment is incision and drainage [2-5]. The use of antibiotics after drainage is controversial but if they are prescribed, should cover Staph aureus.
- Pearl: The incision for the I&D should be made distal to the distal interphalangeal joint on the ulnar side for digits 2-4 and the radial side for the thumb and 5th digit [2]. A digital block should be considered from adequate analgesia during the procedure. See EM:RAP HD for a video review of the felon I&D procedure.
References:
- Rosh, Adam. Rosh Review website. Accessed April 22, 2021. https://www.roshreview.com/.
- Stapczynski, JS, Tintinalli, JE. Musculoskeletal Disorders: Felon. Tintinalli’s emergency medicine: A comprehensive study guide, 8th Edition. New York, NY: McGraw-Hill Education; 2016: 1924.
- Nardi NM, McDonald EJ, Schaefer TJ. Felon. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 20, 2020. PMID: 28613683.
- Koshy JC, Bell B. Hand Infections. J Hand Surg Am. 2019;44(1):46-54. PMID: 30017648.
- Rerucha CM, Ewing JT, Oppenlander KE, Cowan WC. Acute Hand Infections. Am Fam Physician. 2019;99(4):228-236. PMID: 30763047.
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Using Baking Soda for Splinter Removal: How to Try It
A splinter is a sliver of foreign material that gets lodged under the skin. Splinters are most often wood but can also be thorns, glass, metal, or other foreign objects. If you’ve ever had a splinter, you know they can be both annoying and painful.
If possible, you should remove a splinter right away to prevent infection. For tiny splinters that aren’t too bothersome, though, it’s sometimes best to just wait for the splinter to rise to the surface of the skin and then remove it with tweezers.
Even after waiting, sometimes there isn’t enough of the splinter sticking up to grab with tweezers. But there’s another way to remove it that doesn’t involve poking around your already throbbing finger with a pair of tweezers or a needle.
This is where baking soda comes into play.
While this life hack may seem odd, it can be useful for splinters that are more deeply embedded in the skin. The baking soda method is quite simple but does require a little patience.
While this method hasn’t been tested in controlled clinical studies, baking soda is thought to work by increasing osmotic pressure in the skin.
The skin is a semipermeable membrane. When you apply two unequal substances, like water and baking soda, to the skin, the skin will absorb the mixture. And this leads to a change in osmotic pressure.
Increasing osmotic pressure causes the skin to swell up and drive the splinter to the surface.
The process for using baking soda to remove a splinter is as follows:
- Wash your hands.
- Mix 1/4 teaspoon of baking soda with water to form a paste.
- Clean the skin around the splinter with soap and water.
- Apply the paste to and around the splinter.
- Place a sterile bandage on top.
- Leave the bandage on for 24 hours, and then remove it. The splinter should be sticking out at this point.
- Sterilize a pair of tweezers using alcohol or heat.
- Use the tweezers to pull the splinter out.
- Apply antibiotic ointment to the affected area after removing the splinter.
If you still don’t see the splinter after removing the bandage, repeat the process until the splinter works its way out.
The traditional go-to methods to remove splinters are tweezers and needles. But there are several other natural remedies that some people say also help remove splinters.
Duct tape
If the splinter is very small and already near the surface but you can’t seem to grip it with tweezers, try using a piece of sticky tape, like duct tape.
To try this method:
- Gently press a small piece of tape over the area containing the splinter.
- Wait up to 30 minutes.
- Slowly peel back the tape. Try to pull the tape in the opposite direction that the splinter entered the skin.
This method may be better for children than using tweezers since some children (and some adults) may find tweezers a little scary.
Banana peels or potato skins
Like baking soda, banana peels and potato skins are thought to help with splinter removal by causing the skin to swell up and push the splinter out.
To try this method:
- Slice off a small section of the banana peel or potato skin and place it skin side up against the splinter.
- Cover with a bandage and leave it on for a few hours or overnight.
- After removing the peel or skin, remove the splinter with a pair of tweezers.
- Wash the area thoroughly with soap and water, apply antibiotic ointment, and cover with a bandage until the wound heals.
Essential oils
You can also try soaking the area in essential oils, such as lavender oil or tea tree oil, in an attempt to draw out the splinter. To prevent skin reactions due to using potent essential oils, always dilute with a carrier oil.
To try this method:
- Clean the area of skin containing the splinter.
- Soak the splinter in the diluted essential oil for a few minutes.
- Once the splinter rises closer to the surface of the skin, use a sterilized pair of tweezers to remove it.
While research suggests there are health benefits, the FDA doesn’t monitor or regulate the purity or quality of essential oils. It’s important to talk with a healthcare professional before you begin using essential oils and be sure to research the quality of a brand’s products. Always do a patch test before trying a new essential oil.
While splinters might seem like a minor medical issue, there are a few reasons you may want to visit a doctor.
Splinters pose a high risk of infection. This is because a foreign body can introduce bacteria and other germs under the skin’s surface, where they can multiply.
You should see a doctor for the following:
- large splinters that break off under the skin
- splinters that are deeply lodged and can’t be removed despite your best efforts
- splinters that cause extreme pain
- splinters with barbs, like fishhooks, that may be difficult to remove without causing pain
- a splinter that’s near a vein or has caused bleeding that won’t stop
- a splinter made of glass that can’t be easily removed in one piece
- a splinter that’s underneath a fingernail or toenail
- symptoms of an infection, such as redness or flushing, warmth, oozing pus, fever, and chills
- a deep splinter, if you haven’t had a tetanus booster in over 5 years
Medical emergency
If you have a splinter in your eye, call 911 or go to the nearest emergency room.
Baking soda is one of several methods that can help force a splinter to rise to the surface of the skin, where you can more easily remove it with tweezers.
No matter which method of splinter removal you choose, be sure to first wash the area with soap and water and sterilize any tweezers or needles you’ll use to pull the splinter out. Sterilizing the tool before use reduces the risk of infection. And you can sterilize tweezers or needles using alcohol or heat.
Check the area carefully afterward to make sure that no pieces remain under the skin. For very large splinters, splinters in the eye, or splinters that seem infected, contact a doctor.
from finger, foot, heel, under the nail, in a child or adult
Article content:
- Causes of splinters
- Symptoms
- Methods for removing a shallow splinter
- Removal of deep and invisible splinters
- Splinter danger
- Treatment of complications after a splinter
- Wound care after a splinter
- Prophylaxis
A splinter is a foreign body that has entered under the skin. Every person has faced this problem at least once in their life. With a splinter, you need to properly provide medical care, otherwise it will fester. But not everyone knows how to pull out a splinter at home and in what cases you need to see a doctor.
Causes of splinters
Splinters most often affect people working with wood, metal and plants without protective clothing and special gloves. Conventionally, the causes of splinters can be divided into three groups:
- Household. These include cases where a splinter appeared at home: for example, a person walked on a wooden floor or came into contact with small sharp objects. In children, splinters often dig into the skin of the palms, feet and finger phalanges.
- Production. Joiners, carpenters, grinders, etc. often face such a problem. Most often, the hands suffer from splinters, but sometimes a foreign body can get into the skin of the face or other parts of the body. This is especially true for those who do not wear protective clothing and equipment.
- Agricultural. Working with flowers, vegetables, and some plants can also lead to splinters. This is dangerous – tetanus pathogens can be found in the ground. If a person scratches the skin, then a wound forms on it, which can become the entrance gate for the development of a dangerous infection.
Symptoms
Common signs of a splinter:
- soreness;
- redness and swelling of the skin at the site of injury;
- tingling on pressure;
- trace with drops of blood.
If a splinter gets under the nail, then there is a strong throbbing pain. Pain is aggravated by pressing on the nail plate. If the wound is not treated in time, inflammation and suppuration will develop. In this case, pain, swelling and redness increase, and an abscess forms at the site of tissue damage.
Ways to remove a shallow splinter
You can remove a small splinter from your hand, finger, leg, under the nail and other parts of the body at home. Before proceeding with the removal of a foreign body, you need to properly prepare for the procedure:
- Thoroughly clean the wound from dirt. To do this, it is enough to rinse the skin under clean warm water.
- Blot the wound with a tissue to remove excess moisture. It is strictly forbidden to put pressure on the wound or rub it, as this will provoke the advancement of a splinter into the deeper layers of the skin.
- Examine the splinter, determine what it consists of and how deep it is. You can use a magnifying glass for this.
- Treat the wound with an antiseptic solution to prevent infection.
There are several ways to remove a shallow splinter:
- Needle or tweezers. If one end of the foreign body sticks out, then it can be grabbed with tweezers and slowly pulled out. If the fragment is deeper, then you first need to break the epidermis with a needle, and then grab and remove the splinter with tweezers.
- Soda. It is used to remove small fragments. Mix a teaspoon of baking soda with a teaspoon of water. The resulting mixture is applied to the wound and fixed with a band-aid. Within 4-5 hours, the skin will soften and become loose, and the fragment will come out on its own.
- Wax or glue. It is better to use ordinary PVA glue. It must be applied to the wound and left to dry completely. After that, the adhesive layer is carefully removed along with the foreign body.
- Steaming. In a deep container, mix 2 tablespoons of salt and a glass of hot water and steam the wound for 20-30 minutes. When the skin softens, it is wiped dry and gently pressed on the splinter – it will come out by itself.
Removal of deep and invisible splinters
It is better not to remove deep splinters yourself. If something is done wrong, it will only penetrate deeper into the skin. In cases where the injured area hurts, but the splinter is not visible, you should consult a doctor. In both situations, self-medication can exacerbate the problem. In addition, it is strictly forbidden to independently remove a splinter from the eye.
But if you need help quickly, here are a few ways to deal with deep and invisible splinters:
- Compress. Apply a compress soaked in Ichthyol ointment, Levomikol or Vishnevsky ointment to the wound and leave for 6-7 hours. After a while, the foreign body will come out along with pus.
- Removing glass shard. The glass shard should be removed from the body at the angle at which it entered the skin. First, spread the edges of the wound, grab the glass with tweezers and pull it out. Before this, treat the skin with an antiseptic.
- Removal of a splinter in a child. To make the procedure painless, it is better to first steam the skin with hot water. Then you need to divert the attention of the child and quickly remove the foreign body with the tweezers.
If the splinter cannot be removed, go to the emergency room. Take your vaccination card with you, which shows the dates of vaccination against tetanus.
Danger of splinters
If the foreign body is not removed from the skin in time, the following complications will inevitably arise:
- pain will intensify, swelling and redness will appear;
- tissues become inflamed;
- suppuration and panaritium will begin – a purulent process in the tissues.
A splinter breaks the integrity of the skin, forming an open wound. This is the gateway for many infections that are transmitted by contact. One of the most dangerous is tetanus.
Treatment of complications after a splinter
Sometimes after removing a splinter, unpleasant symptoms persist. Most often there is soreness, swelling and redness. To improve well-being and quick healing, it is recommended:
- take an anti-inflammatory drug to relieve inflammation and pain;
- apply healing ointment;
- undergo a course of physiotherapy treatment.
If unpleasant symptoms persist for a long time or worsen, it is recommended to make an appointment with a doctor. You may need to drink a course of antibiotics or open the abscess to drain the pus and fully heal the tissues.
Wound care after a splinter
Wound care at home is aimed at accelerated healing and prevention of undesirable consequences. The injury site should be regularly treated with an antiseptic, a healing ointment applied and a band-aid worn. To prevent infection from getting into the wound, you need to make sure that the crust that forms at the site of the injury is not damaged.
Prevention
Simple recommendations will help prevent a splinter from getting into the body:
- use protective equipment during work: gloves, shoes, clothes, glasses;
- Minimize contact with small sharp objects;
- Do not walk barefoot on untreated wood.
Article published on : 12/22/2015
Last updated : 03/20/2023
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Splinter, swollen finger
Splinter, swollen finger
298
hipp0 familiar face 08.01.14 16:40
08.01.14 16:40
please advise what can be done:
an hour ago a splinter entered the thumb pad, 2.5 centimeters large,
I pulled it out, my finger swelled up very much I can’t go to the hospital – 2 kids, I’m alone.
what can be applied at night or what can be done to make it easier? while I made a compress from a local antibiotic and anti-abcesssalbe, so far what I found ..
it looks like I didn’t pull everything out. I breastfeed.
Thank you
#1
BloodRina bloodthirsty 01/08/14 18:00
NEW 01/08/14 18:00
in reply to hipp0 01/08/14 16:40, Last modified on 01/08/14 18:00 (BloodRina)
Squeeze out everything that is squeezed out, disinfect and cool. Within an hour, the finger was swollen not from the infection, but rather from the fact that you were picking it.
go, fight and seek… find and hide again!!!
#2
hipp0 familiar face 01/08/14 18:47
NEW 01/08/14 18:47
in reply BloodRina 01/08/14 18:00
blood pressed, but only a couple of drops came out, nothing was picked..
#3
mulechka cor resident 01/08/14 19: 02
NEW 01/08/14 19:02
in reply hipp0 01/08/14 16:40
warm soda-salt solution
just keep your finger in it
#4
palna your man 08. 01.14 19:30
NEW 08.01.14 19:30
in reply to hipp0 08.01.14 16:40
Betaisodona ointment on the wound under the patch. Baths can be done with Braunollösung.
You don’t have to go to the hospital. It will be enough if you show your finger to the surgeon one of these days. The family doctor sometimes simply does not have sterile trifles for treating wounds, etc.
Let someone go to praxis with you, so that you can safely get to the doctor, it is not necessary to leave the kids at home. Girlfriend or one of the relatives.
Make sure that the finger does not swell more than it already has in size. If the pulsation is added, the whole will turn red, the pain will become aggravated – it will be a high time to run to the doctor. With burrs and splinters, and not far from panaritium. And with him+ with two little children, put out the light.
Kratze hier ▒▒▒▒▒▒▒▒▒▒▒▒ mit einer Münze,
und finde heraus, ob Du der Gewinner
best!
#5
misterdzam visitor 08.