Treating a fingertip wound

February 20, 2006 2:49 PM

Is it OK to leave some gauze stuck to a wound?

My wife sliced the tip of her finger yesterday, nasty but not bad enough for an E.R. visit. Once we got the bleeding controlled, we wrapped her fingertip in a gauze bandage, with some polysporin, and taped it up.

This afternoon she tried to change the bandage, but it's stuck to the wound pretty good. She's averse to pain, so giving it a good yank is out of the question. We've tried soaking it in warm salt water, but even after a few hours of that nothing's coming loose.

Can we just trim off the excess and leave the gauze there? (The part that's stuck is probably a quarter inch, on the side of her fingertip.) Or is that going to mess up the healing? If it's better to remove it, is there anything beyond warm water that we can try?

posted by ParsonWreck to health (16 comments total)

IANAD, but I was involved in an accident some time ago that tore a significant amount of flesh and muscle from the area of my arm just below my elbow. After consulting with a doctor, I was advised that in order for the wound to heal properly I had to pack the hole daily with strips of gauze that would innevitably stick to the healing tissue and have to be torn away the next day. It was necessary though to do this in order for the wound to continue healing properly and also so that I could properly sanitize it. I would not suggest leaving the gauze, and the pain may just be something she has to bear.
posted by Bondrake at 3:05 PM on February 20, 2006

Well, the gauze gives it something to clot to. If you yank it off, it might yank out a bit more than you want. Might cause a bit of a scar. If it won't be too much of a PITA, you oughta consider having her go to the doctor. It kind of sounds like it's a bit more severe of a cut than you think. :-)

/me is not a doctor, but does deal with sick & injured people.
posted by drstein at 3:12 PM on February 20, 2006

I second the "go to a doctor" thing.... just remember, you don't necessarily need to go to the E.R.- you should be able to schedule an appointment with a GP, or (gulp!) even a walk-in clinic.
posted by crazyray at 3:19 PM on February 20, 2006

IANAD but I would guess a long soak in warm water might loosen the gauze enough to be safetly removed. It will also clean the wound some more. I am a fan of soaking. I think you can try it with nothing to lose.
posted by snowjoe at 4:25 PM on February 20, 2006

A few months ago I had the exact same problem. After receving a nasty cut, gauze was applied, and since it hurt too badly to mess with it, I just left it alone overnight thinking that I would take it off in the morning.

It hurt to even gently tug on it, and I tried various menthods to try and aid the removal (soaking, steam, lots of crying) to no avail. Since I'm far too poor to go the doctor, I went to a pharmacy to ask a pharmacist what he thought. He told me I had to try and remove it, and that I should probably go to the emergency room for stitches.

That was just flat-out not an option. I have a friend who was in med school and he told me (after also going through a similar experience) that there was no problem with just leaving the gauze there. Despite seeing his recovered wound with no gauze imbedded in it permanently (which was my main, misguided concern), I didn't really believe him. I spent the next week or so freaked out every day that this gauze was just going to be a permanent part of my finger. I did clean it often, as I was also very worried about infection, and applied neosporin every day. I also pretty much constantly kept it bandaged, as it hurt to much to be exposed.

Eventually I was able to peel the gauze off without any pain, leaving behind a virtually fully healed finger. This may not have been the best way to handle it, but I'm pretty sure if she goes to a doctor, they'll want to remove the gauze, which just turns my stomach to think about. I do have a scar, but I think that would have happened either way.

Good luck, and please let us know what you decide to do!
posted by a red so deep at 4:57 PM on February 20, 2006

You don't want foreign body granulomas forming inside the tip of your finger. Get that gauze out of the wound.

In future, do not place anything inside a wound that you would not put in your eye. Let me repeat that: do not place anything inside a wound that you would not put in your eye.
posted by ikkyu2 at 5:17 PM on February 20, 2006

No, I'm serious. Would you put that in your eye? No? Then don't put it in the wound.
posted by ikkyu2 at 5:18 PM on February 20, 2006

So much of this is dependent on what the wound is like: how deep, how dirty and the like. It's easy to get stuff like tissues, paper towels and gauze stuck on a wound, and most of the time it's ok: the stuff is just stuck on the outside, and will come off with some work (softening it up, or yanking it off).

Instead of just telling you that your wife should go see a doctor, let me tell you what would probably happen if she were to go see one with a fresh laceration. Questions asked of her/answered through exam:
- How did you cut it?
- What did you cut it with?
- Are you up to date with your tetanus booster?
- How deep is it?
- Any signs of infection?
- Is sensation intact?
- Is motor function intact?
- Any foreign bodies?

Then her doctor may:
- Clean the wound out with a lot of sterile saline
- Numb the finger up
- Place some sutures
- Dress the wound appropriately
- Give a tetanus booster
- Give some antibiotics.

That's a general outline of what would be done for any type of laceration involving a finger. I guess I'm trying to convince you that even seemingly trivial wounds require some amount of work. In your wife's case, the gauze may be taken off, the whole wound may be cleaned up, and exploration may be performed to see if there's anything stuck inside. If the gauze doesn't come off, there's really no way to tell if there's a foreign body; it's stuck to clotted blood, and the blood may be clotting around something that shouldn't be there (see ikkyu2's posts above). At the same time, the doc might just say: "hell, looks ok, no signs of infection, don't sweat it."

If someone were to come to me with your wife's presentation, I'd soak the gauze in saline, remove it, and examine the wound closely. If someone were to call me with your wife's story, I'd ask to see her, and do the same thing. In the meantime, I'd tell them to watch out for any new pains, swelling, redness, change in temperature, change in sensation, or pus. Any of those would mandate immediate examination, and not merely an office visit the next day.
posted by herrdoktor at 6:12 PM on February 20, 2006

In my personal experience.
Soaking in warm water and hydrogen peroxide can soften a scab up.

of course I'm also the guy who superglued a cut closed because I didn't have the cash for emergency room stitches and visit. (if my mother the nurse ever finds out about that one she is giving me a beating)
posted by Megafly at 6:16 PM on February 20, 2006

Megafly: I read "of course I'm also the guy who superglued a cat closed". Yikes!
posted by evariste at 7:21 PM on February 20, 2006

Don't screw around with wounds involving your hands. You need to remove the gauze. Soak it more.
posted by desuetude at 8:18 PM on February 20, 2006

Would you put hydrogen peroxide in your eye?
posted by ikkyu2 at 9:45 PM on February 20, 2006

Noise, I know, but ikkyu2—if it'd foam up something wicked, definitely. Cool party trick!
posted by disillusioned at 11:00 PM on February 20, 2006

I've got a doozy of a scar on my right calf, where I had a nasty fall off my bike whilst doing some XC. I cut my leg on the chainring. A quick fix in the field involved a lot of TCP (disinfectant), some cotton wool (cotton balls), and some superglue. It stung, a lot, but the bleeding stopped, and I didn't die.

And no, ikkyu2, I wouldn't put that stuff in my eye.
posted by veedubya at 2:43 AM on February 21, 2006

Thanks AskMe for all the thoughts.

ikkyu2's advice sealed it. (FWIW, we also remembered about Telehealth, and while I'm sure the nurse there just read from a script, it was the kick in the arse my wife needed to suck it up and see a professional.) The doctor did exactly what herrdoktor described, minus the sutures.

Cheers!
posted by ParsonWreck at 6:23 AM on February 21, 2006

For what it's worth I've had gauze get stuck in a wound only to have it scar, then open 10 years later. Removing the gauze at that time allowed the wound to heal and the scarring to minimize.

Also, it's worth noting that there is a difference between gauze and kerlix. Kerlix is not cottony. It is stringy and therefore difficult to lose any in a wound. Highly recommended.
posted by kc0dxh at 7:47 AM on February 21, 2006