Knives are out for holiday cooking. What to do about hand and finger injuries
You cut your hand while slicing a bagel; nearly lost a fingertip while using a power saw; or your usually friendly feline decides to bite you hard during a belly rub. Do you:
- Slap some antibiotic ointment and a Band-Aid on it and forget it?
- Go to an urgent care clinic?
- Go to a hospital emergency department?
“Urgent care is the best way to get a look at the wound,” said Peter E. Bentivegna, MD, FACS, a hand surgeon and reconstructive plastic surgeon. Depending upon the type and severity of the wound, clinic providers can clean and dress it, and stitch it, or do an X-ray, if a fracture may be suspected. The provider may refer patients for follow-up with a hand surgeon.
“The hand is a very fine instrument. Any kind of swelling” should be investigated, he said.
The majority of his hand injury patients come through Cape Cod Healthcare’s network of urgent care clinics, said Dr. Bentivegna, who practices at Cape Cod Plastic and Hand Surgeons, in West Yarmouth. If it’s a severe injury, urgent care can send patients to an emergency department. Dr. Bentivegna said he and five other local hand surgeons are on call at Falmouth and Cape Cod hospitals' emergency departments to deal with those cases.
“Hand injuries account for about 25 percent of injuries that come into the emergency room,” he said. “We’ve always done more trauma than you’d expect.”
Cat Bites and More
Dr. Bentivegna said he performed the first “replant” – or reattachment – of a finger on Cape Cod, and noted that his training included a fellowship in treatment of burns.
“We do a lot of small burns. If you have a massive burn, you’ll be transported by helicopter to a burn center,” he said.
Dog bites and, especially, cat bites need to be seen right away for cleaning and antibiotic treatment. Dog bites may look worse, as they rip open the skin, but those wounds will usually drain, he said. Cat bites cause puncture wounds that can penetrate through the skin into a tendon sheath, introducing bacteria where it will not drain from the wound without a surgeon opening it up.
“It causes horrendous infection within 24 hours,” Dr. Bentivegna said. Ignore a cat bite and “within 48 hours they’ll need to be admitted to the hospital.”
Most finger wounds don’t require surgery, he said. They can be cleaned up and treated with a few stitches.
Treatment by a hand surgeon will typically include follow-up with an occupational therapist, Dr. Bentivegna said. Successful treatment involves “a triangle” – the patient, the hand surgeon and the therapist. Often patients lose some grip strength or have other issues after surgery that therapy can address.
“Most traumatic or infectious problems of the hand; they will mostly need therapy.”
Infections from hand wounds can cause adhesions on tendons, he said. A hand surgeon may have to determine if swelling and inflammation resulted from an infection, cellulitis or some other condition, such as gout, pseudogout or rheumatoid arthritis.
