Why Doctors May Not Always Try to Save a Fingertip
We started talking last week about how to decide if a common injury -- a bleeding cut on a finger -- requires medical attention. If the bleeding stops when you press on it for a few minutes, then you probably do not need a doctor. But if the injury is more serious, then you could suffer permanent damage unless you get help.
Dr. Martin Brown is chairman of emergency medicine at Inova Alexandria Hospital in Virginia. He says injuries that damage a "deep structure" like a bone, tendon or nerve should always be treated by a doctor.
MARTIN BROWN: "When deep structures are involved, it's a different ballgame."
Forceful bleeding and bright red blood are dangerous signs of a deep cut. Dr. Brown says there are different medical products that can help stop the bleeding. One example is Gelfoam.
MARTIN BROWN: "Gelfoam is a cellulose product that promotes the clotting of blood by giving blood sort of a matrix upon which to clot."
The traditional way to close a serious cut is with sutures, also known as stitches. A needle and nylon thread are used to sew the edges of the wound together.
But Dr. Brown says a more recent development is a medical glue.
MARTIN BROWN: "That's a glue that's very similar if not identical to super glue, but it's a sterile form of that."
Super glue makes many things stick together. But Dr. Brown says people should not use it on injuries. He says the medical glue can be used when a cut is straight and comes together easily.
The American Academy of Orthopaedic Surgeons has advice on its website about what to do if a fingertip is not just cut but cut off.
First, gently clean the amputated part with water or saline. Dr. Brown says people can use a saline cleaner for contact lenses. Saline contains salt.
Next, without drying the fingertip, cover the part in gauze or a cloth. Place it in a waterproof bag and place the bag on ice. Do not put the amputated part itself directly on ice. That could damage it more.
Bring the fingertip to a hospital as quickly as possible.
A surgeon may try to reattach a fingertip that is cut off below the first joint. But Dr. Brown says fingertips are not often reattached if they are the length of a fingernail or shorter.
He says a reattachment operation can take many hours.
MARTIN BROWN: "It's not a simple procedure by any means. It's done under a microscope, reattaching nerves and arteries and tendons."
Even then, he says, the result will not necessarily be better than losing part of a finger. Dr. Brown says patients must also be willing to undergo a rehabilitation process to regain use of the finger.
MARTIN BROWN: "Reattachment is a real commitment by the patient and the doctor. Amputation is a simple thing."