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First Aid/Cut open side/bottom of thumb

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Question
ah, the hazards of Mandolins, but the love of home made potato chips.  While using said Mandolin yesterday, I (while protecting the tips of my fingers), managed to remove a chunk of skin from the side and under part of my thumb, right where the joint is as my fingers were bent.  The 'flap' of skin is still there, but barely hanging on.  I put peroxide on it, tucked the skin back on (although not straight as I was in panic mode) and wrapped with neosporin and gauze, but it is still bleeding slightly, and hurts like the dickens.  Not numb (although I would take that at the moment), but tingling, but you can see (and this is gross), a bit of 'meat', and some whitish stuff I am hoping is fat but Im pretty slender so...  Any thoughts on treating this at home?  I have insurance, but I have a deep aversion to needles (aka stitches or shots), so trying to avoid that if possible.  Thanks!

Answer
Hello Jennifer,

If it's a larger "avulsion" of a knuckle, and it's been a day or so it's probably not suturable. I would advise against peroxide on wounds, it tends to destroy, wash away cells and tissue. I would advise keeping the wound clean, keep putting neosporin on the wound, and watch for signs of infection (Redness, swelling, discharge, increasing pain, or if the area is unusually warm to the touch.

Good luck Jennifer, I hope you heal quickly.

Marc

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Marcus LaBarbera

Expertise

I am available to answer most questions related to: first aid, pre- hospital medicine, EMT and Paramedic questions, medical transport, critical care transport, ICU/CCU care, sedation, and medicine in general.

Experience

I have worked as a NYS Paramedic since 1993 for both community based ambulance companies and large commercial agencies. I Have experience as bike team commander, and shift supervisor for a commercial ambulance. As a member of the Disaster team I was deployed to Louisiana for 20 days following hurricane Katrina. I worked along side the county Haz-Mat team as a "Tox-Medic" with advanced training in treating injuries from chemical agents. Besides my experience on the on the ambulance I have worked in a number of hospital based offices including dialysis and a sleep lab.

Education/Credentials
I started my EMS career as a NYS CFR (Certified First Responder)in 1989, an EMT in 1991, a Paramedic since 1993, and a CCU transport paramedic since 2005. I currently hold certification as a: NYS Paramedic, Critical Care Transport Paramedic, ACLS/CPR/PALS certified. Advanced Haz-Mat Life Support certified (AHLS). In the past I have taught CPR and ACLS to my coworkers and the local community.

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