Managing Finger Injuries: When to Seek Medical Help and Care Tips

A piece of flesh from the little finger and nail has been removed?

On March 28, I went to the emergency room due to continuous bleeding.
The doctor used electrocautery to stop the bleeding and prescribed a medication ointment (gentian violet ointment).
During my follow-up visit, after changing the dressing, the doctor advised me to change the dressing every 3 to 4 days and not to change it too frequently, as it could disrupt the scab formation.
However, today when I changed the dressing, I noticed that the scab had stuck to the gauze and came off, causing bleeding again.
I have cleaned the wound with saline and reapplied the ointment and bandaged it.
Should I return to the hospital for electrocautery again, or should I wait a few days and see how it goes? I tend to accidentally bump my hand, and the injured area feels sharp pain sometimes; I’m not sure if that’s causing the bleeding.
Additionally, I would like to ask whether the doctor recommends using cotton gauze or non-woven gauze.
After scabbing, should I continue applying the ointment? (Because I have been continuously applying the ointment.)

Ms. Zeng, 30~39 year old female. Ask Date: 2021/04/05

Dr. Ke Fangxu reply Surgery

If bleeding from a wound can be stopped by applying pressure, there is no need to return to the hospital for a dressing change.
It is recommended to first soak the area with sterile saline before gently removing the gauze to minimize the risk of bleeding.
Either cotton or non-woven gauze can be used to apply ointment to prevent the wound from sticking to the gauze.
If the wound has dried and formed a scab, there is no need to apply ointment again.

Reply Date: 2021/04/05

More Info

When managing finger injuries, it's crucial to understand the appropriate steps to take for effective healing and when to seek medical help. Based on your situation, it seems you have experienced a significant injury that required emergency treatment, including cauterization to stop the bleeding and the application of a topical antibiotic ointment. Here are some insights and recommendations regarding your concerns.

When to Seek Medical Help
Given that you have already experienced bleeding after changing the dressing, it is advisable to monitor the situation closely. If the bleeding persists or if you notice increased pain, swelling, or signs of infection (such as redness, warmth, or pus), you should return to the hospital for further evaluation. The fact that your scab came off with the dressing indicates that the healing process is still delicate, and any disruption can lead to further bleeding or complications.

Care Tips for Finger Injuries
1. Dressing Changes: It is generally recommended to change the dressing every few days or as needed, especially if it becomes wet or soiled. However, if the scab is still forming, you should avoid removing it prematurely, as it serves as a natural barrier to protect the wound. If you notice that the scab has come off and bleeding has resumed, you may need to apply gentle pressure to stop the bleeding and then reapply a clean dressing.

2. Cleaning the Wound: Using saline solution to clean the wound is a good practice. It helps to remove debris without causing additional irritation. After cleaning, applying a thin layer of antibiotic ointment can help prevent infection.

3. Type of Dressing: Regarding your question about the type of dressing to use, both cotton gauze and non-woven fabric dressings have their benefits. Non-woven dressings are often preferred for their ability to wick away moisture and reduce the risk of sticking to the wound, which can be beneficial in preventing the scab from coming off prematurely. However, if you find that cotton gauze is more comfortable for you, it can also be used effectively.

4. Continued Use of Antibiotic Ointment: It is generally advisable to continue using the antibiotic ointment until the wound has healed sufficiently. However, once the wound has formed a stable scab, you may not need to apply the ointment as frequently. It's essential to follow your doctor's advice regarding the duration and frequency of ointment application.

5. Avoiding Irritation: Be cautious with the injured area to avoid further trauma. If you notice that certain activities cause pain or irritation, try to modify your movements to protect the injury. If the area is sensitive, it may be a sign that the healing process is still underway, and you should avoid putting pressure on it.

Conclusion
In summary, while it is essential to care for your finger injury at home, you should not hesitate to seek medical attention if you experience any concerning symptoms. Proper wound care, including appropriate dressing changes and monitoring for signs of infection, is crucial for healing. If you have any doubts or if the situation worsens, returning to the hospital for a follow-up is always a wise decision. Remember, your health and recovery are the top priorities.

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