Tag Archives: Hangnails

Straight, No Chaser: Human Bites

Infectious Disease, Skin/Dermatology, , , , , , , , , , , , , , , , , ,

fight-bite

I have had weird experiences with humans biting humans, as have most physicians. There are several different types of human bites, which can range from harmless to surgically serious. However, as an emergency physician, knowing the dangers of the bacteria inhabiting your mouth, I tend to assume the worst until proven otherwise. Your first quick tip is to do the same.

fight bite infected

Maybe it’s where I’m located, but I tend to see way more “fight bites” than anything else; these specifically refer to someone getting hit in the mouth. It’s always interesting to see the guy who “won” the fight being the one who has to come in for medical treatment. He cut his hand on someone’s tooth and really doesn’t think much of it. He just wants the laceration sewn. Little does he realize, the structures in the hand (tendons, blood vessels, muscles, and bones) are highly concentrated. He also doesn’t know that they are confined to a very limited space and seeding an infection in that tight space makes things really bad really quick. This guy is very dangerous because he tends to deny ever getting into the fight, ascribing the injury to something else (like punching a tree)—at least until I ask him why a tooth is inside his hand.

tysonbite

Then there’s the “Yes, he bit me” variety, where the teeth were the aggressor that engaged the victim instead of the fist engaging the tooth. Think of the Tyson vs. Holyfield bite as an example. Sometimes parts get bitten off (fingers, nose, ears, and other unmentionables)! Children, as another example, sometimes bite and need to learn to stop that behavior. Biting is sometimes seen in sexual assault, physical abuse, self-mutilation, or with mentally handicapped individuals.

human-vampires-bite--large-msg-135111099475

A third type is the ‘We love too much!’ variety of bites. These may include hickeys that actually break the skin. Other examples of “friendly” bites are folks biting off their hangnails, fingernails, and toenails and create skin infections. Yes, it happens more than you’d think, and no, you don’t have to be a vampire.
The commonality to all of these scenarios is saliva that found its way through the skin. Because of the virulence of the bacteria contained within the saliva, an infection will be forthcoming. You’ll know soon enough when the redness, warmth, tenderness, fever, and possible pus from the wound develop.
The easy recommendation to make is anytime a wound involving someone’s mouth breaks your skin, get evaluated. Some wounds are much more dangerous than others. Teeth get dislodged into wounds, hand tendons get cut, bones get broken, and serious infections develop. In fact, these bites require immunization for tetanus.
Bottom line: There’s no reason not to get evaluated if you develop those signs of infection, if any injury to your hand occurs, or if any breakage of your skin has occurred. You’ll need antibiotics and wound cleaning in all probability, with a tetanus shot if you’re not up to date. If you’re unlucky, you may end up in the operating room.

human-bite

So here’s your duty if you haven’t successfully avoided the bite:
1) At home, only clean the open wound by running water over the area. Avoid the home remedies like peroxide, alcohol, and anything else that burns. Those agents make things worse by damaging the skin more than they “clean” the area.
2) Apply ice—never directly to the wound—but in a towel. Use for 15 minutes on and then 15 minutes off.
3) Retrieve any displaced skin tissue, place it in a bag of cold water, place that bag on ice, and bring it with you. We’ll decide if it’s salvageable.
4) Get in to be evaluated. Be forthcoming about whether or not it was a bite.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Human Bites

General Health and Wellness, , , , , , , , , , , , ,

fight-bite

I have had weird experiences with humans biting humans, as have most physicians. There are several different types of human bites, which can range from harmless to surgically serious. However, as an emergency physician, knowing the dangers of the bacteria inhabiting your mouth, I tend to assume the worst until proven otherwise. Your first quick tip is to do the same.

fight bite infected

Maybe it’s where I’m located, but I tend to see way more “fight bites” than anything else; these specifically refer to someone getting hit in the mouth. It’s always interesting to see the guy who “won” the fight being the one who has to come in for medical treatment. He cut his hand on someone’s tooth and really doesn’t think much of it. He just wants the laceration sewn. Little does he realize, the structures in the hand (tendons, blood vessels, muscles, and bones) are highly concentrated. He also doesn’t know that they are confined to a very limited space and seeding an infection in that tight space makes things really bad really quick. This guy is very dangerous because he tends to deny ever getting into the fight, ascribing the injury to something else (like punching a tree)—at least until I ask him why a tooth is inside his hand.

tysonbite

Then there’s the “Yes, he bit me” variety, where the teeth were the aggressor that engaged the victim instead of the fist engaging the tooth. Think of the Tyson vs. Holyfield bite as an example. Sometimes parts get bitten off (fingers, nose, ears, and other unmentionables)! Children, as another example, sometimes bite and need to learn to stop that behavior. Biting is sometimes seen in sexual assault, physical abuse, self-mutilation, or with mentally handicapped individuals.

human-vampires-bite--large-msg-135111099475

A third type is the ‘We love too much!’ variety of bites. These may include hickeys that actually break the skin. Other examples of “friendly” bites are folks biting off their hangnails, fingernails, and toenails and create skin infections. Yes, it happens more than you’d think, and no, you don’t have to be a vampire.
The commonality to all of these scenarios is saliva that found its way through the skin. Because of the virulence of the bacteria contained within the saliva, an infection will be forthcoming. You’ll know soon enough when the redness, warmth, tenderness, fever, and possible pus from the wound develop.
The easy recommendation to make is anytime a wound involving someone’s mouth breaks your skin, get evaluated. Some wounds are much more dangerous than others. Teeth get dislodged into wounds, hand tendons get cut, bones get broken, and serious infections develop. In fact, these bites require immunization for tetanus. Bottom line: There’s no reason not to get evaluated if you develop those signs of infection, if any injury to your hand occurs, or if any breakage of your skin has occurred. You’ll need antibiotics and wound cleaning in all probability, with a tetanus shot if you’re not up to date. If you’re unlucky, you may end up in the operating room.

human-bite

So here’s your duty if you haven’t successfully avoided the bite:
1) At home, only clean the open wound by running water over the area. Avoid the home remedies like peroxide, alcohol, and anything else that burns. Those agents make things worse by damaging the skin more than they “clean” the area.
2) Apply ice—never directly to the wound—but in a towel. Use for 15 minutes on and then 15 minutes off.
3) Retrieve any displaced skin tissue, place it in a bag of cold water, place that bag on ice, and bring it with you. We’ll decide if it’s salvageable.
4) Get in to be evaluated. Be forthcoming about whether or not it was a bite.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: Hangnails and Paronychia

Skin/Dermatology, , , , , ,

hangnail

Aren’t hangnails annoying? Well, it gets worse. The things we do in an effort to get rid of them cause even bigger problems, and that’s the focus of this Straight, No Chaser.

 hangnail1

We’ve previously discussed the dangers of human bites. Every time you nibble on your fingers or bite off a hangnail, you’re potentially planting the seeds of a bacterial, yeast or fungal infection in your finger (depending on what’s in your mouth or on your hands); such an infection is called a paronychia. Paronychia can be caused by other types of injuries to the area around your fingernails, such as the manicures you can’t do without (in this example, the specific problem is cutting or pushing back the cuticles).

 paronychia

You likely already know how these look. They resemble a less violent version of an ingrown toenail, with pain, redness and swelling at the involved area of the finger. More severe infections can also reveal pus-filled mini-abscesses and can cause changes to the color or shape of your nails. If you’re very unlucky or have a reduced immune system (e.g., diabetes, HIV, chronically on steroids) the infection can spread to your tendons, bones or bloodstream.

 ParonychiaID

Given that treatment of these can involve use of antibiotics or the need for an incision and drainage procedure (as is done with other abscesses), you might want to avoid that pain and follow these tips for prevention and treatment.
To prevent paronychia:

  • Wash your hands to keep unwanted bacteria, yeast and fungi off your hands. That’s a pretty good start.
  • Don’t bite or pick your nails.
  • Use gloves when they’re available. If you’re working with detergents and chemicals, these substances damage the nails and fingers.
  • Speak up and forbid the use of any manicure tools that aren’t new or newly sterilized. If you don’t see the tools coming out of the bag, you’re introducing risk to your hands.

Hangnail-Removal-Tool-Nippers-e1378933807774

  • Say no to getting your cuticles cut. All that does is help unwanted microorganism enter your body. It’s even worse when blood is expressed from a cuticle cut.

 hangnailbite

In general, good nail care can prevent the hangnails that initiate many of these problems. Trim your fingernails every week and your toenails about once a month. Trim your fingernails with a slightly rounded edge, but your toenails should be cut more straight across. Always leave some of the edge of the nail (the white portion) intact. Use an emery board for smoothing the edges. You’re less likely to cause damage if you trim your nails while wet, such as after bathing or showering.

 paronychiasoak

If you have pain, redness and swelling after manipulating a hangnail or biting your fingers or toes, soaking your nail in hot water two to three times a day can help reduce swelling and pain. If things don’t get better, or if you develop fever, chills, joint or muscle pain or see an extension of the area of redness, these are clear signs that you need to see your physician.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com(SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight No Chaser: Human Bites

Health Prevention, Medical Treatment, , , , , , , , , , , , , , ,

tysonbite
I have had weird experiences with humans biting humans, as have most physicians. There are several different types of human bites, which can range from harmless to surgically serious, but as an emergency physician knowing the dangers of the bacteria inhabiting your mouth, I tend to assume the worst until proven otherwise. Your first Quick Tip is to do the same.
Maybe it’s where I’m located, but I tend to see way more ‘fight bites’ than anything else; these specifically refer to someone getting hit in the mouth. It’s always interesting to see the guy who ‘won’ the fight being the one who has to come in for medical treatment. He will have cut his hand on someone’s tooth and really doesn’t think much of it. He just wants the laceration sewn. Little does he realize how concentrated all of the structures (tendons, blood vessels, muscles and bones) are in the hand. He also doesn’t know that they’re confined to a very limited space, and seeding an infection in that space makes things really bad really quick. These guys are very dangerous because they tend to deny ever getting into the fight, ascribing the injury to something else (like punching a tree) – at least until I ask him why a tooth is inside his hand.
Then there’s the “Yes, I was bitten” variety, including activity where the teeth engaged the victim instead of the fist engaging a tooth. Think of the above Tyson vs. Holyfield bite as an example. Sometimes parts get bitten off (fingers, nose, ears and other unmentionables)! Children sometimes need to learn to stop biting as a behavior. Biting is sometimes seen in sexual assault, physical abuse and in self-mutilating behavior or with mentally handicapped individuals.
A third type is the ‘We love too much!’ variety. These may include hickeys (that actually break the skin), folks biting off their hangnails, and individuals who create skin infections by biting their toenails and fingernails. Yes, it happens more than you’d think.
The commonality to all of these scenarios is saliva found its way through the skin. Because of the virulence of those bacteria contained within, an infection will be forthcoming. You’ll know soon enough when the redness, warmth, tenderness and possibly pus from the wound and fever develop.
The easy recommendation to make is anytime a wound involving someone’s mouth breaks your skin, you need to be evaluated. Some wounds are much more dangerous than others. Teeth get dislodged into wounds, hand tendons get cut, bones get broken, and serious infections develop, and in fact these bites require immunization for tetanus. Bottom line: there’s no reason not to get evaluated if you develop those signs of infection I mentioned, if any injury to your hand occurs, or if any breakage of your skin has occurred. You’ll need antibiotics and wound cleaning in all probability, with a tetanus shot if you’re not up to date. If you’re unlucky, you may end up in the operating room.
So here’s your duty if you haven’t successfully avoided the bite:
1) At home, only clean the open wound by running water over the area. Avoid the home remedies, peroxide, alcohol and anything else that burns. You’re making things worse for yourself (those agents cause skin damage more than they’re ‘cleaning’ the area).
2) Apply ice – never directly to the wound, but in a towel. Use for 15 minutes off then 15 minutes on.
3) Retrieve any displaced skin tissue, place it in a bag of cold water, place that bag on ice, and bring it with you. We’ll decide if it’s salvageable.
4) Get in to be evaluated. Be forthcoming about whether or not it was a bite.