Tag Archives: puncture wound

Straight, No Chaser: Your Questions About Human Bites

Skin/Dermatology, Medical Treatment, Infectious Disease, , , , , , , , , , , , , , , , , , , , ,

jaws

The votes are in, and it appears that Jaws (from James Bond fame) found the previous post, well… biting.  Here’s your questions and answers about human bites:
1)   If human bites are so dangerous, why do women love Dracula so much?

  • Seriously?  Let’s just ascribe it to the neck being an erogenous zone and move on…

2)   What’s a Boxer’s Fracture?

fight bite

  • A boxer’s fracture is a misnomer because boxers don’t get them.  This describes a fracture at the base of the small finger (5th metacarpal), often caused from poor form throwing a punch.  If you take one hand and move the pinky finger portion of the palm (the metacarpal bone), you’ll notice how movable it is (i.e. unstable) compared with the same efforts on the index and middle fingers at the level of the palm, which is what should deliver the blow.  A boxer’s fracture and a human bite together makes for a very bad day.

3)   Is a human’s mouth really dirtier than a goat’s mouth?

goat lip

  • It’s correct to say the bacteria in a human’s mouth cause more disease.

4)   Is a bite the same as a puncture wound

  • The difference between a puncture wound and a laceration is you can identify the bottom (base) of the wound in a laceration, and you can’t in a puncture wound.  Regarding bites: cats, snakes and the aforementioned Dracula are more likely to cause puncture wounds.  Puncture wounds may or may not be caused by a bite (e.g. knife wounds are punctures).

human-reflex-bite

5)   I received a bite and didn’t get stitched up.  Why?

  • This could be for several reasons.  Puncture wounds don’t receive stitches because you don’t want to seal off the infection.  That’s a really good way to develop an abscess.
  • Sometimes we will opt for ‘delayed closure’, waiting 3-5 days to ensure no infection has occurred before placing stitches.
  • It’s really about the risk/benefit ratio.  A laceration to a face is more likely to be repaired because of the risk of disfigurement and scarring, plus the face is a relatively low infection area anyway.

6)   Why didn’t Dracula ever get Hepatitis or HIV?
dracula_bites_kim_kardashian_by_the_mind_controller-d5jh3ix

  • Even though Dracula’s the undead, one would think he’d be the world’s single greatest transmitter of both HIV and the blood transmitted forms of Hepatitis.  HIV is viable for awhile in dead tissue, but it can’t multiply, which would explain why Dracula doesn’t show signs of the diseases.  On that note, I’m done.

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.
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Straight, No Chaser: Your Questions About Human Bites

Skin/Dermatology, Medical Treatment, Infectious Disease, , , , , , , , , , , , , , , ,

jaws

The votes are in, and it appears that Jaws (from James Bond fame) found the previous post, well… biting.  Here’s your questions and answers about human bites:
1)   If human bites are so dangerous, why do women love Dracula so much?

  • Seriously?  Let’s just ascribe it to the neck being an erogenous zone and move on…

2)   What’s a Boxer’s Fracture?

fight bite

  • A boxer’s fracture is a misnomer because boxers don’t get them.  This describes a fracture at the base of the small finger (5th metacarpal), often caused from poor form throwing a punch.  If you take one hand and move the pinky finger portion of the palm (the metacarpal bone), you’ll notice how movable it is (i.e. unstable) compared with the same efforts on the index and middle fingers at the level of the palm, which is what should deliver the blow.  A boxer’s fracture and a human bite together makes for a very bad day.

3)   Is a human’s mouth really dirtier than a goat’s mouth?

goat lip

  • It’s correct to say the bacteria in a human’s mouth cause more disease.

4)   Is a bite the same as a puncture wound

  • The difference between a puncture wound and a laceration is you can identify the bottom (base) of the wound in a laceration, and you can’t in a puncture wound.  Regarding bites: cats, snakes and the aforementioned Dracula are more likely to cause puncture wounds.  Puncture wounds may or may not be caused by a bite (e.g. knife wounds are punctures).

human-reflex-bite

5)   I received a bite and didn’t get stitched up.  Why?

  • This could be for several reasons.  Puncture wounds don’t receive stitches because you don’t want to seal off the infection.  That’s a really good way to develop an abscess.
  • Sometimes we will opt for ‘delayed closure’, waiting 3-5 days to ensure no infection has occurred before placing stitches.
  • It’s really about the risk/benefit ratio.  A laceration to a face is more likely to be repaired because of the risk of disfigurement and scarring, plus the face is a relatively low infection area anyway.

6)   Why didn’t Dracula ever get Hepatitis or HIV?
dracula_bites_kim_kardashian_by_the_mind_controller-d5jh3ix

  • Even though Dracula’s the undead, one would think he’d be the world’s single greatest transmitter of both HIV and the blood transmitted forms of Hepatitis.  HIV is viable for awhile in dead tissue, but it can’t multiply, which would explain why Dracula doesn’t show signs of the diseases.  On that note, I’m done.

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. Preorder your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com.

Straight, No Chaser: Step on a Nail? What Happens Next?

General Health and Wellness, Infectious Disease, Orthopedics/Bones, , , , , , ,

StepOnNail

What would you do if you stepped on a nail? What if the nail was rusty? Does it make a difference if you were wearing shoes? Is stepping on a nail dangerous? Why does everyone pronounce tetanus “teknus?” For the answers to these questions (well maybe not the last one) and more, read the rest of this Straight, No Chaser!
It’s an interesting thing that so many nails are allowed to stay on the ground until they become rusty. One would think either they’d be picked up or that you wouldn’t be walking around barefooted in unknown areas. We’ve discussed puncture wounds previously, and stepping on a nail is an example of a puncture wound. However, there are some important considerations that make it worthwhile to discuss.

 footnail

What should you do if you step on a nail?
Assuming the nail isn’t stuck in your feet, clean your foot vigorously. If the nail is superficially struck in your foot, it’s likely you will have reflexively yanked it out. That’s ok as long as the wound isn’t significantly bleeding at the time.
It’s prudent that you call your physician for next instructions, but in most cases you’ll be directed to come to the emergency room.

 foot_nail-350

What’s the issue?
There is no one issue. There are several potentially significant consequences of stepping on a nail.

  • If the skin was sliced instead of punctured, that’s a laceration, which will need to be addressed.
  • It makes a huge difference if you were wearing shoes or not, and not in the way you might think. Stepping on a rusty nail is a much more dangerous proposition if you did so while wearing rubber soles. One of the more dangerous bacteria we have to deal with (named Pseudomonas) thrives in rubber. The puncture from grass or ground through the sole of a rubber shoe into your foot may plant this bacteria superficially or deeply into your foot, causing one (or several) of many different types of infections.
  • Rusty nails can produce tetanus, which is almost always fatal. This is why you get immunized at least every decade for this disease. You wouldn’t want your worse enemy to suffer a death from tetanus (at least I’d hope not).

 foot infection from nail

What kind of infections can you get from this?
Skin infections are common after puncture wounds involving nails, and can include the following:

  • Cellulitis – a straightforward infection of the skin
  • Abscesses – those walled-off “pus pockets” that sometimes require incision and drainage to make it go away
  • Osteomyelitis – the bones deeper into the foot can actually become chipped and/or infected as well

These are significant wounds, especially if rubber soles are involved, and they may even require surgery to clean the area. In some instances (especially when you have certain risk factors) skin ulcerations (breakdown of the skin) can occur, making severe infection more likely. In some of these instances, foot amputation is necessary.
In addition to wearing rubber-soled shoes at the time of the injury, these other conditions place you at risk for a worse outcome.

  • Cancer
  • Diabetes
  • Malnutrition
  • Reduced immunity
  • Smoking history

The infections associated with nail-induced puncture wounds are potentially serious and hard to treat. Patients sometimes end up hospitalized with weeks and sometimes months of treatment with antibiotics.
In case you think the take home message is it’s better not to wear shoes or sandals when walking through the house, grass or sand, you’re partially correct. My best advice to you is look before you weep.
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: Your Questions about Human Bites

Medical Treatment, , , , , , , , , , , , , , , ,

dracula_bites_kim_kardashian_by_the_mind_controller-d5jh3ix
It seems that you found today’s post, well… biting.  Here’s your questions and answers about human bites:
1)   If human bites are so dangerous, why do women love Dracula so much?

  • Seriously?  Let’s just ascribe it to the neck being an erogenous zone and move on…

2)   What’s a Boxer’s Fracture?

  • A boxer’s fracture is a misnomer because boxers don’t get them.  This describes a fracture at the base of the small finger (5th metacarpal), often caused from poor form throwing a punch.  If you take one hand and move the pinky finger portion of the palm (the metacarpal bone), you’ll notice how movable it is (i.e. unstable) compared with the same efforts on the index and middle fingers at the level of the palm, which is what should deliver the blow.  A boxer’s fracture and a human bite together makes for a very bad day.

3)   Is a human’s mouth really dirtier than a goat’s mouth?

  • It’s correct to say the bacteria in a human’s mouth cause more disease.

4)   Is a bite the same as a puncture wound?

  • The difference between a puncture wound and a laceration is you can identify the bottom (base) of the wound in a laceration, and you can’t in a puncture wound.  Regarding bites: cats, snakes and the aforementioned Dracula are more likely to cause puncture wounds.  Puncture wounds may or may not be caused by a bite (e.g. knife wounds are punctures).

5)   I received a bite and didn’t get stitched up.  Why?

  • This could be for several reasons.  Puncture wounds don’t receive stitches because you don’t want to seal off the infection.  That’s a really good way to develop an abscess.
  • Sometimes we will opt for ‘delayed closure’, waiting 3-5 days to ensure no infection has occurred before placing stitches.
  • It’s really about the risk/benefit ratio.  A laceration to a face is more likely to be repaired because of the risk of disfigurement and scarring, plus the face is a relatively low infection area anyway.

6)   Why didn’t Dracula ever get Hepatitis or HIV?

  • Even though Dracula’s the undead, one would think he’d be the world’s single greatest transmitter of both HIV and the blood transmitted forms of Hepatitis.  HIV is viable for awhile in dead tissue, but it can’t multiply, which would explain why Dracula doesn’t show signs of the diseases.  On that note, I’m done.