All of the stitches were removed from my thumb today...
The doctor indicated that the wounds are healing okay - not as well as could possibly be hoped, but not bad either.
The small, upper laceration is looking pretty good. There was more blood pooling under the large, lower flap than would have been ideal, which caused some of the severed portion to lose viability - a nice way of saying that some of the fileted skin is dead. The doctor is hopeful that the center portion forward to the edge near the nail will survive, but the edges will probably end up drying up and curling up, and will have to be trimmed away as the new meat grows underneath. He explained that there just wasn't enough area at the base of the cut to provide enough blood flow to support all of the lacerated tissue, and that's why the edges didn't survive and reattach.
The suture removal wasn't too bad, except for one area where the skin tore a bit.
I still have a wrap-around pressure dressing on the entire thumb, but it is much less bulky now, and I am no longer using the splint, which makes my right hand a little more useful. The doctor told me to continue to "baby" the thumb for a few more days, and that I should also wait a few more days before I start trying to do much bending of my thumb at the knuckle. We did an initial mobility assessment, and at the moment, the range of motion is quite limited. The doctor said this was most likely due to the joint being a bit stiff from ten days of non-use, and probably also a bit from my caution about getting too eager and reopening the wound. As long as I still have the pressure dressing on, the whole bending the knuckle is moot anyway, as even the slimmed down version significantly limits the ability to bend my thumb.
Interestingly, today, they applied antibiotic ointment all over the injured area before applying the gauze pad and wrap. Ointment was not used either at the ER, nor at the doctor's office the following day. I guess maybe it was because this was to protect the small exposed areas where the stitch holes were, as well as the torn area. Maybe it also is contradicted while the cut is deep and fresh, or when the sutures are still in place. When I did some research on laceration care on the Internet a few days ago, prevailing practice seemed about equally divided on the question of antiseptic ointment use, although it seemed more generally indicated for superficial cuts not requiring stitches.
I thought about posting some photos, but I decided that would be a bit too gross.
Digg It!
Bookmark it!
Posted by David at May 10, 2006 02:35 PM