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ER Unnecessary For Small Hand Wounds
Posted by: Dr. Mercola
August 21 2002 | 1,350 views

Hand wounds are common simple problems and their treatment requires tremendous resources. Every doctor is asked, "Will this cut needs stitches?" with the expectation that the answer is determined using some scientific knowledge.

Suturing is the most popular method of securely closing wounds, although it has many disadvantages: sutures require

  • The use of needles to inject painful anesthetics,
  • Are time consuming,
  • Have the greatest tissue reactivity of any wound closure device,
  • Are costly, and
  • Are inconvenient for patients.

Normally, wounds repair themselves, regardless of whether wound edges are sewn together. Most doctors have seen wounds that were not sutured and healed normally.

The goal of wound healing is to have a functional and cosmetically appealing scar, and to inflict minimal pain and inconvenience on patients. This study found that for many wounds stitches were unnecessary.

The study found that uncomplicated wounds of the hand, shorter than 1 inch, are currently being sutured unnecessarily and would heal with similar results without sutures.

This is the first randomized controlled trial to determine whether the conservative management of hand wounds produces similar clinical outcomes to wounds that are sutured. The authors were impressed with how inconspicuous most scars were after three months and at the high level of patients' satisfaction with the appearance of their wound.

British Medical Journal August 10, 2002;325:299 (Full Text Article)



Dr. Mercola's Comments:
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This is a study I just love. One that establishes clear guidelines on how we can effectively minimize our use of the ER. How many of us have cut our fingers with a knife while preparing a meal? I have on more than one occasion.

This study provides us firm reassurance that as long as the bleeding is well controlled, the wound is less than an inch or so and no major tendons are cut, it is quite safe to stop the bleeding with an appropriate band-aid after cleaning the wound with soap and water and irrigating with peroxide.

If you elect to treat a wound this way, please be especially vigilant to monitor the wound edges on a daily basis. If you observe a red ring around the wound that starts to spread more than a ¼ to a ½ inch, have it evaluated by a health care professional, as the wound may be developing an infection.

Many already know that Krazy Glue has also been shown to be a very effective wound closure on skin that does not receive much tension or stress. Unfortunately, it doesn't work very well in the hand area for most wounds, but it can provide incredible plastic surgery type healing on many facial wounds if done properly.

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