Hand Injuries (cont.)
IN THIS ARTICLE
Soft Tissue Injuries, Amputations, Infections, Burns, Cold, and High Pressure Injuries Medical Treatment
Soft tissue injuries and amputations
These injuries can be devastating to the hand and the patient. Reattaching (replantation) is difficult, and even if successful may, cause long-term complications with pain and infection. Situations when a surgeon may attempt replantation are amputation involving a child, thumb amputation, or amputation of multiple fingers or the entire hand.
Crush or tear injuries and prolonged delay before evaluation may make successful replantation impossible. Each injury requires an immediate evaluation because each person's circumstances warrant all possibilities to be considered. The type, location, extent, person's wishes, and time of injury all contribute to the treatment plan. Some injuries will require immediate surgery for replantation. Others will require little medical intervention beyond cleansing, bandaging, and allowing the injury to heal. In some locations, the doctors and facilities needed for replantation do not exist.
Fingertip and nail infections may be treated in the clinic or emergency department with incision and drainage (if indicated), antibiotics, and close follow-up. A major consideration for an infection in the hand is the presence of a fluid collection or an abscess. If the infection is isolated to the skin, known as cellulitis, treatment involves antibiotics and close follow-up. However, an abscess requires drainage (sometimes known as "lancing"). If the abscess is large or near nerves, arteries, ligaments, or tendons surgery may be necessary for treatment. Hand infections have the potential for rapid progression leading to severe loss of function.
Serious burn injuries to the hand may require an evaluation by a hand or burn surgeon. Hospital admission may be required for treatment. Multiple operations including skin grafting may be needed in order to ensure the best outcome.
Third-degree burn and deep second-degree burns
High pressure injuries
Medically Reviewed by a Doctor on 12/15/2014
Chad Tarr, MD
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