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Ninjahedge
05-04-2009, 11:58 AM
Question for all of you. Yesterday I managed to slice the top of my thumb almost off with a serrated knife while slicing a lemon in two.


Ouch.


I applied pressure to it, but it was a real bleeder. I put some neosporin on it and held it for a good 15 minutes before gently rinsing it, getting more blood, then liquid bandaging it and band-aid/taping it up.

Worked OK until later when tucking in my shirt to go out and I split the seal and it started bleeding again. I pressed it tight, rinsed it a bit and taped it up.

Now I have more liquid bandage on it, a band-aid on top of that, and a "finger condom" (cot). The cot is snipped and taped at the end to prevent water from coming in.

Question is this. If it costs me $250 to go to an emergency room, is it really worth it if (knock on wood) it is not swollen, infected or (currently) bleeding? What is the magic "stitch size"?

Opinion?

Wes
05-04-2009, 12:09 PM
ouch! i would go to emergency room!

garm
05-04-2009, 12:22 PM
Unless you have blood issues (known coagulation or vitamin K issues) I wouldn't go - just keep the bandages clean by regularly changing them. No major arteries in the tip of the thumb anyhow - just arterioles.

Stitches only required if you worry about scares.

$250 - wow :(

Ninjahedge
05-04-2009, 02:35 PM
Emergency room copay baby!!!

And the E-room in Hoboken has a really bad rep. If there was just a doctor I could go to to get it done (w/insurance) for $50 or so I would have gone.

I was not worried about bleeding to death, but this was a little gusher! After the adrenaline wore off I let the worries hit me. Man that sucks, I can see why so many guys injured in battle go through so much AFTER.

Once that adrenaline goes away, your emotions flip over.

shifty
05-04-2009, 03:15 PM
if it's so deep that you can see muscle, or it is red, swollen AND tender, go see a doctor, otherwise don't bother. don't go to the ER if it's not an emergency - simple solution to not paying a copay.

i've sliced stuff with knives frequently. i just took a chainsaw to my arm weekend before last also, too. here are pictures: http://camura.com/albums/view/234

normally i never go for stitches. with the case of the chainsaw, it was like ... i could see muscle and fat and some bone (you can see fat and muscle below), and it was a centimeter or two away from my radial artery and a massive load of tendons, and deep enough that i couldn't tape it back together...so i went for stitches. but no pain, no excessive bleeding. after i saw it and verified i could move all my fingers normally, i walked into the garage, got a clean paper shop towel, applied pressure, put away the chainsaw, the extension pole, the 12' ladder, the extension cord, then closed up shop and walked up to ask my wife to take me to the ER for some stitches. it could have been much worse.


in shop class sophomore year of high school i sliced a nail in half with a band saw and never went. i fell on an oyster bed hands first when i was a single-digit kid and gashed my hand open to the bone and never saw a doctor or got stitches (shoulda). so many things you just don't need to bother going over. it's when things swell and hurt and turn read (the body's natural indicator of a problem - pain, swelling, color) you need to worry.

http://camura.com/post/orig/91174

Ninjahedge
05-04-2009, 04:42 PM
Ook......

I see the other scoremarks down the arm too... Looks like it skittered a bit until it found your wrist.


Ick ick ick.

Ah well, I guess I am just relegated back to the digit-tip-slicer. It does not look too bad, yet, and I feel itching but no real acheyness, no bleeding I can see all day at work, and no real pain even if I gently (accidentally) tap it.

It is annoynig as hell to find out how many things you, even as a righty, use your left thumb for. The really tricky thing is, since it is not immobilized, I sometimes catch myself using it (or about to) w/o thinking.

Thanks for the gore!

shifty
05-04-2009, 05:10 PM
skittered after finding my wrist. was cutting tree trunk (last limb of the day) on the ground. limb had a hooked piece that was tied up in another tree. as i finished the cut, the tree branch hooked in the other tree, swung around and knocked the trigger hand (shown) off of the throttle/trigger, and the chainsaw right back into that same wrist. so, upside is the chainsaw was in the process of stopping (the blade). downside was, the blade was sharp as hell and coming down at a great force, resulting in what you see - the slice was what stopped the blade; the rest was scrape from the blade/etc. coming back onto my arm.

either way...it sucked. didn't hurt a bit. hasn't gotten infected. took the stitches out last night before bed, tossed a butterfly on it so i didn't rip it open while sleeping, and crashed out. looks good today.

never had an ounce of pain during the whole ordeal or the followup, except a slight rugburn feeling the next day which passed within a few hours. the worst part was the slight tickly burn when the doc shot me with local anesthetic to do the stitches. told him not to bother, i've given myself stitches w/o anything, huge pain threshhold on my side, but he wouldn't go for it.

btw, do you know how to properly hold and use a knife? like, curling your fingers over, etc? because if you were using your knives properly, it should be theoretically impossible to cut your digits. maybe shred a knuckle, but never cut a tip. not to say i didn't nick nails here and there with my new Global eastern-style knives when i got them, but ... that was from working them too fast.

example of what i mean: http://media.wiley.com/Lux/00/88400.image0.jpg

you should aways be doing that (maybe not to that extreme) when cutting almost anything, especially round items like onions and lemons. start by cutting it in half longways, then lay on the flat side to slice

Dr. Death
05-04-2009, 07:01 PM
I sliced off the end of my thumb also. The consensus with all the nurses I know is don't seal it up, leave it open. I had a flap of skin that was partially attached and I was going to superglue it back on. They said no, you'll just seal in any infection.

I started with neosporin and peroxide. Then taped it up with gauze and tape. Kept treating it until the skin flap sealed itself back on. (Eventually it dried up and fell off like a blister.) After a while, I was putting two bandaids on, one over the top and another around to keep dirt out and help the over the top one stay on.

It's fine now...no infection, no scar even.

Things YOU should be concerned with are: How deep is your cut? How clean was the knife? (I assume fairly clean since you were slicing food.) When was your last tetanus shot?

shifty
05-04-2009, 10:10 PM
Note: peroxide kills tissue. It is bad.

Slayer
05-05-2009, 01:20 AM
That looked nasty there shifty. I am always careful with those things, because of what I have see and heard of what they can do.

Example: My brother, a very long time ago(in his younger, stupider days) was cutting wood with a chainsaw like you, and accidently cut into his thigh(about 12 inches long). Since he was by himself and in the middle of nowhere he tied a tourniquet on his leg jumped into his car and drove 18 miles at over 90 mph to our home town and made it as far as the front of the fire station, where he passed out in the car.

He was lucky to be alive.

Dr. Death
05-05-2009, 01:58 AM
Yes, peroxide interferes with healing. I should have mentioned that I used the peroxide only once, initially. The rest of the time I just used the antibiotic cream.

Ninjahedge
05-05-2009, 08:52 AM
Shift, as for using knives, I was holding the lemon and cutting it in half away from me.

2 things were my downfall.

1. I was curling my fingers around it too much. My thumb should have never been that far around.

2. For some reason I twisted a bit while doing it, making the cut get slightly shallower on tha back end, and then just grazing my thumb (1/8 to 1/4 an inch, max).


That's all it takes. Done dozens of them like that before no problem, I guess I got sloppy... :( (General thing that happens in life. Sometimes it is the EXPERIENCED guy that gets hurt because he just stops being as careful as the n00b....)