I cut my finger. Pretty badly?
September 16, 2011 4:48 PM   Subscribe

Hospitalfilter: I cut my finger a few hours ago and somehow managed to peel a bit of skin. Is this something I need to see a doctor about or can I roll with hydrogen peroxide, bactine, and gauze? I have insurance but I don't have a doctor, so if I have to see one, I'll have to go the ER. Pics are a touch gross. http://amandawaller.imgur.com/finger
posted by nooneyouknow to Health & Fitness (18 answers total) 1 user marked this as a favorite
First, off, don't use hydrogen peroxide. It's an open wound. Also, when my mom had a puncture wound (cat bit her), the doctor told her that hydrogen peroxide impedes healing because it kills the outer cells.

As far as seeing a doctor... hard to say. If it isn't bleeding, I think the main problem would be with the skin repairing itself. You might be able to get by if you put neosporin on it and bind it with a bandage. Also any chance you cut anything other than skin?
posted by DoubleLune at 4:54 PM on September 16, 2011

IANAD, IANYD, this is not medical advice, etc.

I grew up under the (possibly very mistaken) assumption that the only reason to go to a doctor after a cut was if a) the cut didn't stop bleeding on its own after half an hour or so, b) you think you cut tendon or can see bone or something else gnarly, or c) you cut it on a rusty barbed-wire fence or something and need a tetanus shot.

However, I should note that my father is a big fan of the "eh, tape it to its healthy neighbor, you'll be fine", so YMMV.
posted by stellaluna at 4:55 PM on September 16, 2011

If it just got the top layers of flesh, I'd just bandage it up (and you're gonna have a nifty scar!). If it goes down farther than that, off you go.
posted by deezil at 4:58 PM on September 16, 2011 [1 favorite]

If you decide to go to the doctor, see if you can find an urgent care center that's open in your area. They tend to be far more pleasant on a Friday night than an emergency room.
posted by PhoBWanKenobi at 5:00 PM on September 16, 2011

That is gross! No, you are fine. Assuming the wound stops bleeding on its own and is not deep enough to hit tendons or other useful stuff you need to use your finger, you are probably okay. That said, if you have insurance, I bet dollars to donuts that there is a 24 hour nurse line that comes along with it and you could call them to just get a second professional opinion. The only thing I'd worry about is forming scar tissue as it's healing that would affect your finger mobility, so make sure that as it heals you bend your finger a lot so that it's flexing and not scarring.

Signs of infection are heat, redness, swelling and/or pus (also pain that does not go away). If any of these are happening, it's a good idea to check in with the doc. My rule of thumb is that unless you see weird red streaks on your hand, you are not in OMG GO NOW territory.

Keep it covered until the wound closes, check to make sure it's stopped bleeding, keep it very clean, do not mess with it and check it again in a few hours to make sure it appears to be getting better not worse.
posted by jessamyn at 5:00 PM on September 16, 2011

I had a cut just like that on the back of my thumb. I put anti-bacterial ointment under the flap and covered the whole thing with a band-aid. It healed up in a week or two, albeit with a nasty scar. You probably don't need to see a doctor unless it becomes infected.
posted by embrangled at 5:01 PM on September 16, 2011

If it were my finger I'd close it with some butterfly closures and then bandage it. The closures are to keep it in place for a few days while still being able to change the dressing effectively. When I've had to do this I can't see how it's any less effective than stitches on most kinds of cuts, but then I'm a filthy human who is not a doctor.
posted by cmoj at 5:03 PM on September 16, 2011

IANAD, blah blah you know the drill.

I agree with DoubleLune, don't use peroxide. If it were my finger, I'd be advising: if you have antiseptic wipes/ointment, use that after you wash it REAL good, keep it clean and dry, slap some gauze over it so it can get some air yet be protected against casual contact (or a breathable bandaid, whatever). Check it regularly, clean it more than you think you should, replace the bandage about once a day or when it starts looking really worn. When it looks more or less healed (you probably know your own body) feel free to remove the bandage and show everyone your awesome new scar. (Bonus points if it's your middle finger, so you can go 'LOOK I CUT MY FINGER :D' and hold it up. Heh heh ...)

I had a nasty cut on the side of my finger once and the ER nurse I talked to said it wouldn't even be worth it to stitch up. There's not enough skin there and it's too small to do anything with.
posted by Heretical at 5:07 PM on September 16, 2011


I would not go to the doctor for this. I ripped the top of my knuckle off a few years ago while helping my (then) boyfriend move. (Why he couldn't carry his own damn recliner up the stairs, I'll never know.) Anyway, the chair slipped, and the footrest mechanism sprung out and nearly tore off the entire knuckle, save for a tiny strip of skin. It looked pretty heinous.

I used hydrogen peroxide to clean it off (worked fine for me), put the skin back to where it was supposed to be, bandaged it up really well with gauze and tape, and kept the wound clean and the dressing changed regularly for several days. It eventually healed.

I've got a scar, but you can barely even see it because it happens to fall really well on the natural knuckle folds.

So: it's scary when it happens, it's a bitch and a half to deal with (because it's on a finger, and you use your fingers for everything), but it will all be ok without doctor intervention. Sounds like you're doing fine so far.
posted by phunniemee at 5:07 PM on September 16, 2011

Count me among those who wouldn't go to the doctor, but with one recommendation I haven't seen yet:

Cut a Telfa pad to size and put that between the wound and the gauze. That will make it a lot easier and less painful when you go to change dressings.
posted by buggzzee23 at 5:18 PM on September 16, 2011

What did you cut it on? When was the last time you had a tetanus shot?
posted by TheBones at 5:39 PM on September 16, 2011 [3 favorites]

IANAD, and you can probably not go to the doctor, but if it gets red and swollen, or especially if you see red lines moving away from the wound on the skin and towards the heart, make sure you do go to a doctor, because you don't want to mess with an infection. (I've had MRSA more than once, and it's no picnic, so I'm very paranoid about open wounds.)
posted by xingcat at 6:20 PM on September 16, 2011

A good cut. I've had a million billion cuts just like it; worked with sheet metal and also with metal studs, either of those you're just going to end up cutting yourself lots of times. Very annoying.

I doubt very seriously that any doc would sew it; I wouldn't go to one anyways, was it me.

Lots of that triple anti-biotic salve-y glop that you buy in a tube at Walgreens or wherever, then bandaids to keep it all gooped up, then (I would, for sure -- your call) another layer of some tape around the bandaids. NOT tight; as Jessamyn said, you want the thing to move, plus it's going to swell tonight.

If you keep that thing covered and gooped up you'll be amazed at how fast it'll heal, and it'll move fine, too, and it won't hardly hurt at all, once over this initial thing. When you're changing out bandaids, the skin is all soft and white and resolving nicely; in my experience, that stuff really does make it fast by keeping it moist and infection free.
posted by dancestoblue at 6:32 PM on September 16, 2011

First, off, don't use hydrogen peroxide. It's an open wound. Also, when my mom had a puncture wound (cat bit her), the doctor told her that hydrogen peroxide impedes healing because it kills the outer cells.

I totally did not know this. This first aid text confirms that and says that you shouldn't even use antiseptics like alcohol or iodine on it:
DO NOT irrigate a wound with full-strength iodine preparations such as povidone iodine (10%) or isopropyl alcohol (70%). They kill body cells as well as bacteria and are painful. Also, some people are allergic to iodine.
It says to irrigate with water and endorses using antibiotic ointment.

(The wound care instructions and caveats at that link may be useful to the OP.)
posted by XMLicious at 6:45 PM on September 16, 2011

No need for the ER. I had a cut like this and I washed it with water and antimicrobial soap (hibiclens, which is a hospital-grade cleanser I happen to have in the house, but plain old unscented soap would be fine). Then I put on some Neosporin and wrapped a bandage around it snugly. It healed up just fine, though I had a little crevice in my finger for a bit. I don't even have a scar.
posted by bedhead at 7:33 PM on September 16, 2011

Thanks everybody. I've put away the hydrogen peroxide, slathered it in Neosporin and will keep a watch out for anything hinky. The cut is shallow and it looks like it's mostly stopped bleeding. FYI, I cut in on the hanger bar in my closet - no rusty nails. I think I was freaking out a little bit, cause my coworker told me yesterday about one of her friends who got some kind of cut and it went septic.

P.S. It's kinda hard to type when your finger is covered in gauze.

posted by nooneyouknow at 7:36 PM on September 16, 2011

Doctor here. Lots of clean running water, sterile if you can manage it, maybe a liter running directly into the wound. Then hold pressure with clean/sterile gauze for as long as it takes to stop the bleeding but if it's still brisk after 30 minutes, you've got a wound that will likely be more convenient for you to manage with stitches. Some guidelines recommend no stitches if it's been more than six hours since the injury (infection risk too high) or if the wound is less than 1 cm (on the hand).

If you haven't had a tetanus booster in the last 10 years, I would recommend getting one in the next 72 hours.

Peroxide is maybe ok to help clean out a dirty wound initially, but absolutely don't keep using it. Once the wound is initially cleaned and the bleeding is stopped, I would dress it and leave it alone, keeping it totally dry for the first 24 hours just to give that first layer of epithelium a chance to form. Thereafter, keep it covered if that is what is needed to protect it, I would clean it once a day or when dirty with a gentle stream of water and maybe a mild soap but no scrubbing.

All of this assumes there is no tendon damage (your finger moves in all the normal ways right?) and that you don't have a laceration deep into a joint space -- those things mandate seeing a doctor.

I can't really tell from your picture, but it looks like maybe you have a highly angled laceration. If so, the tip of the triangle likely doesn't have enough blood supply and will necrose and fall off, not much you can do about that, I'd leave it in place for now but if it's clearly dead skin in the next few days, I'd use some fine sterile scissors to trim that off (this is potential food for infection).

Finally, if it gets real red or pusses out, you gotta get seen. Do not fuck around with hand infections in the slightest.
posted by Slarty Bartfast at 10:32 PM on September 16, 2011 [5 favorites]

It doesn't look like anything there needs stitching. A good washing, then anti-bacterial ointment and a telfa/gauze dressing should do the trick.
Watch for any signs of infection.
posted by SLC Mom at 12:10 PM on September 17, 2011

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