Slow Healing Finger Injuries: Causes and Solutions

Fingers are prone to injury, and wounds are difficult to heal?

Hello Doctor: Over the past two years, my fingers have frequently been injured, such as cuts from knives or injuries resembling paronychia when trimming my nails.
Each time, the wound expands from a small point to an area about half a centimeter in length and width, making it difficult to heal.
I consistently disinfect with alcohol or povidone-iodine, then use a gel-like liquid bandage or adhesive bandage for small wounds, and I try to avoid getting them wet (though washing my face and showering is unavoidable).
There has been almost no inflammation, but the wounds just won't heal, often taking 2-4 weeks.
The healed skin seems very thin and breaks easily upon contact (for example, using dental floss can cut my finger skin).
Other areas of my body with small injuries (like a large pimple on my scalp that I accidentally burst) heal quickly within a day.
I don't believe I have diabetes; my recent blood test (last December) showed GLU 95 and HbA1C 6.5.
I was a stage 1 lung adenocarcinoma patient and had surgery to remove a lobe of my lung seven years ago, but I did not undergo chemotherapy and have only been monitored regularly without taking any medication.
Eleven years ago, I had a severe case of shingles with large blisters (three large areas), which resulted in 11 years of neuropathic pain.
Recently, I haven't experienced any significant decrease in immunity or high stress (I have been retired for many years).
How should I manage these finger cuts? Could there be other reasons for the slow healing? Do I need to take any vitamins? Which specialist should I see? Thank you.

Thomas, 60~69 year old female. Ask Date: 2021/03/23

Dr. Li Zhonghuai reply Surgery

Hello! There are many reasons for wounds to heal poorly, including diabetes, impaired kidney function, autoimmune diseases (such as psoriasis and rheumatoid arthritis), smoking (including secondhand and thirdhand smoke), alcohol consumption, long-term use of corticosteroids, previous chemotherapy, treatment with biologics, and potential osteomyelitis.
Additionally, wounds should not come into contact with tap water at all (not even a drop); it is crucial to avoid water exposure.
It is important to investigate these various causes and to take preventive measures, such as wearing gloves, socks, and shoes when going out, to avoid injuries.
Stay safe! Changhua Hospital cares about you!

Reply Date: 2021/03/23

More Info

When dealing with slow-healing finger injuries, it's essential to understand the underlying causes and explore effective solutions. Your experience with recurrent finger injuries, such as cuts and hangnails, which seem to take an unusually long time to heal, raises several important considerations.

Causes of Slow Healing
1. Skin Integrity and Thickness: The skin on the fingers is relatively thin and sensitive, making it more susceptible to injury. If the skin is already compromised or thin due to previous injuries, it may take longer to heal. The healing process can be further complicated by repeated trauma, which can prevent the skin from fully recovering.

2. Circulation: Adequate blood flow is crucial for healing. If there are any underlying circulatory issues, this could slow down the healing process. Although your blood glucose levels seem normal, other factors such as peripheral vascular disease could affect circulation in your extremities.

3. Nutritional Deficiencies: Vitamins and minerals play a vital role in wound healing. Vitamin C, for instance, is essential for collagen synthesis, while Vitamin A is crucial for skin repair. Zinc is also important for immune function and wound healing. Given your history of cancer and potential nutritional gaps, it may be beneficial to consider a multivitamin or specific supplements after consulting with a healthcare provider.

4. Previous Medical History: Your history of lung cancer and shingles may have long-term effects on your immune system and skin health. Chronic conditions or past surgeries can influence how your body responds to injuries.
5. Infection and Inflammation: While you mentioned that you have not experienced inflammation, it’s important to ensure that there is no underlying infection, as this can significantly delay healing. Even minor infections can lead to complications if not addressed.

Solutions and Recommendations
1. Proper Wound Care: Continue to clean the wounds with antiseptics like alcohol or iodine, but be cautious with excessive use, as it can irritate the skin. Instead, consider using a gentle saline solution for cleaning. After cleaning, applying a hydrocolloid dressing can help maintain moisture and promote healing.

2. Moisture Retention: Keeping the wound moist is crucial for healing. Avoid letting the wound dry out completely, as this can lead to scabbing and delayed healing. Using a liquid bandage or a specialized wound gel can help maintain an optimal healing environment.

3. Avoiding Further Trauma: Since you mentioned that even minor activities can cause re-injury, it may be beneficial to protect your fingers with gloves during activities that could lead to cuts or abrasions.
4. Dietary Considerations: Focus on a balanced diet rich in vitamins and minerals that support skin health. Foods high in Vitamin C (like citrus fruits), Vitamin A (like carrots), and zinc (like nuts and seeds) can be particularly beneficial.

5. Consulting a Specialist: Given your complex medical history and ongoing issues with healing, it would be wise to consult a dermatologist or a wound care specialist. They can provide targeted treatments and assess for any underlying conditions that may be affecting your skin's ability to heal.

6. Monitoring Blood Sugar Levels: While your recent glucose levels are within normal ranges, it’s essential to continue monitoring them, especially considering your history. Elevated blood sugar levels can impair healing, so maintaining a healthy lifestyle is crucial.

7. Consider Physical Therapy: If you experience stiffness or reduced mobility in your fingers, physical therapy may help improve function and prevent further injuries.

In summary, slow-healing finger injuries can result from a combination of factors including skin integrity, circulation, nutritional status, and previous medical history. By adopting a comprehensive approach to wound care, nutrition, and seeking appropriate medical advice, you can enhance your healing process and reduce the likelihood of future injuries.

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