Modern Wound Management in Hand Surgery
Without our hands, even the simplest everyday tasks become incredibly difficult. All the more sensitive, therefore, is our reaction to injuries of the hand or fingers.
Hands and fingers are the most important tools of human beings. We use them to grasp and work, to touch and feel, and to gesture. These body parts are therefore among the most important in the human body for getting through daily life easily and well. Whether at home, at work or during sports, hands and fingers are our ever-present helpers for both small and large tasks. Because hands and fingers hold this exposed position, the risk of injury is very high.
Cut wounds – one of the most common finger injuries
In countless everyday situations, one can sustain a cut wound. A cut wound occurs when the skin and often the underlying tissue is severed by a sharp object. These include knife blades, but also scissors, shards of glass or paper. One moment of inattention, and you've already cut your finger. Therefore, cut wounds, especially to the fingers, are among the most common injuries of all.
A cut wound typically has smooth wound edges. However, the exact appearance of the cut wound and the accompanying symptoms depend on how deep the injury is. With superficial cut wounds, where only the upper layers of skin are severed, the typical wound pain and relatively minor bleeding usually occur. As long as these wounds are not contaminated by germs, they do not represent a problematic injury. Deep cut injuries, however, can lead to complications. A deep cut wound in which larger blood vessels, tendons or nerves are additionally injured can trigger further symptoms.
Crush wounds on the fingers
Crush wounds are caused by blunt force trauma to the body. Accidents in road traffic, in the household, during sports or at the workplace play a major role here. When crushed, the skin bursts open, so that the wound edges are not smooth but rather irregular. Muscles, tendons, nerves and bones can also be affected.
Since hands are our most important helpers and perform many tasks in everyday life, crushing injuries to the fingers occur particularly frequently, such as from being caught in drawers or doors. The extent of the crush injury depends on the duration and force with which the door or drawer was closed. In addition to crush injuries to the fingers, crushing injuries to other parts of the hand also frequently occur.
Severe crush wounds to fingers, hands or arms generally occur when working with large tools and machinery. The greater the pressure, the higher the probability of drastic injuries, which can even lead to amputations. This occurs, for example, when tissue and bone are destroyed and severed by extreme compression.
Special features of wounds on the hand and fingers
Many minor and light injuries to the hand and fingers heal completely without complications. Nevertheless, injuries to fingers and hands require special attention. Initially seemingly trivial injuries can give rise to major complications in the course of treatment and have far-reaching consequences. This is the case, for example, with superficially small puncture wounds when muscles, tendons and nerves are also affected. Many joints, tendons and nerves in the hand lie in a very confined space and close beneath the skin. Wound care and wound coverage are therefore particularly difficult here. Should complications arise during treatment, these can sometimes have far-reaching consequences. The complications consist essentially of necrosis, infections or wound healing disorders, in which bones and soft tissues can also be affected.
Wound treatment on the fingers and its difficulties
Mobility and sensitivity are of particular importance for the function of the hand. Therefore, good wound care and healing are especially important, but also particularly difficult due to the anatomical conditions. The typical wound treatment for fresh wounds on the hand or fingers consists of surgical wound excision, closure of the wound, e.g. by suturing, followed by immobilization of the wound and its surroundings. However, prolonged immobilization is not always the first-line therapy, as this can lead to irreversible stiffening of joints and scarring adhesion of tendons. Therefore, early intensive movement therapy is sensible and important for many finger injuries. Modern wound management can make an excellent contribution to optimal wound healing here.
We repeatedly find in practice that dressing materials do not adhere correctly or durably to fingers. The movement of the fingers and the sweat glands on the hand make good adhesion of dressing materials even more difficult. However, if a wound is not optimally covered with a good wound dressing, excessive movement can lead to irritation of the wound and even to the wound reopening. The effect of moist wound treatment is also lost. Yet for many wounds, moist wound treatment is the best healing therapy.
Modern wound management can make a major contribution here to restoring hand function as quickly as possible. Modern dressing materials, such as the hydrocolloid or silver rapid wound dressing, as well as anatomically shaped dressing materials, are now indispensable in modern wound management. Particularly for wounds on the fingers, an anatomical finger shape of the dressing in various sizes offers excellent wound coverage. They optimally cover the wound and ensure good moisture retention as well as absorption of wound exudate. This is also a great relief for patients who are experiencing extreme restrictions in daily life due to injuries to their hands and fingers. Modern wound management also offers the possibility of starting the required movement therapy at an early stage without impairing the wound and wound healing.
