Help! I don't want a hole in my thumb!

June 11, 2007 12:50 PM

I cut myself badly today, ripping off a piece of skin about .5cm in diameter right on the knuckle of my thumb. (further gory details inside) - Is there anything I can do tonight to improve healing, or should I leave it alone? - Should I go to my GP or the walk in clinic in the morning

The cut is very deep, with fat attached to the skin. I was home alone on my lunch break, so I tied a bandage around it as tight as I could, which stopped the bleeding, and went back to work. The first aid lady at work looked at it and rebandaged it and said she didn't think it would need stitches, but when she saw it, the flap of skin was sitting nicely in place.

After I got home from work, I dislodged the bandage accidentally, so decided to replace it. The flap of skin stuck to the gauze and came away from the wound. I put it back in place, gauze and all, trimmed the excess bandage away, put a dollop of antiseptic cream on top of the gauze, and put a bandaid over the whole thing.

If the skin doesn't reattach, I'm going to end up with a pit in my thumb from the scar tissue. But at 8 hours since the injury, I'm guessing it's probably too late for stitches, and it's almost bedtime.

Further details: The bleeding has stopped, and there's very little pain. I've lost no function or sensation in my thumb. And the cut was deep enough that there was fat attached to the flap of skin.

posted by happyturtle to health & fitness (7 comments total)

Keep it clean. If you have anything like neosporin, you should probably put some of that on there too. Don't dress it too tightly or it's going to throb like a mofo in the morning. It is too late for stitches, so just keep it dressed and clean and you'll be ok.
posted by Caper's Ghost at 12:53 PM on June 11, 2007

You'll have a groovy scar, but unless you see any signs of infection, don't worry about it beyond bandaging it for a little while. You might think about leaving it unbandaged for a bit between dressing changes. Some seem to think that letting the wound breathe for a while improves healing.

By the way..once it heals, you'll not likely have a pit, you'll more likely have a lump. At least that's what happened to me when I fell off my bed one night into this antique chest that had some protruding metal that gouged a 2cm x 0.5cm slit on my side.

That was over 20 years ago, and it's still the same. I had no treatment other than a band-aid with neosporin for a few days.
posted by wierdo at 1:22 PM on June 11, 2007

Seconding wierdo.

I once cut a pretty significant chunk of flesh out of the tip of the ring finger on my left hand, doing tricks with a butterfly knife (don't try this at home, kids!), and I tore off the unattached flap of skin, thinking it would heal faster/better without it always tearing loose.

Now I have a bump of scar tissue there.
posted by rocketman at 1:32 PM on June 11, 2007

I grated part of my thumb off once with a Microplane. I lost the flap of skin, and the wound was a few millimeters wide and deep, but as it healed (pretty quickly), it filled out, fingerprint and all.

I can't even remember which thumb. YMMV.
posted by stance at 1:46 PM on June 11, 2007

Lots of neosporin. DON'T let it "breathe." It's a myth that this promotes healing. Keep it moist with neo and keep it covered and protected. It takes longer to heal if it's allowed to dry out.
posted by wsg at 1:51 PM on June 11, 2007

Keeping it moist is essential. You don't necessarily need an antibiotic ointment--KY will usually work just fine. And cover that with a nonabsorbant dressing (e.g., a BandAid).

Did a piece of skin become completely disconnected? If so, it won't reattach. Discard it.
posted by neuron at 2:19 PM on June 11, 2007

Former EMT here..

Firstly, just keep it clean and bandaged. Neosporin or similar topical antibiotics are good too.

If you go to the docs, they'll do exactly what everyone else here is suggesting, but by all means if it worries you, dont hesitate to see an actual physician!

It was a little unclear whether or not you actually removed the flap of skin (ie completely) when you redressed the bandage. Once the blood supply is severed completely from any flesh, it dies, so dont leave the skin in place if that has happened. It could very easily get necrotic and infected. You should definately see a physician in that case, especially if the wound is very deep and/or has muscle tissue or bone exposed, even on something as "trivial" as a digit.

Otherwise just take care of it and you'll have a great scar and make up a cool story about saving a coworker while shrapnel was flying about. Worth a drink at a bar some time.
posted by elendil71 at 2:23 PM on June 11, 2007