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Kids cut fingers6/26/2023 After 48 hours, re-suturing is rarely done (except on the face). This is sometimes done if suturing was less than 48 hours ago. The cut may need restitched (or glued) if gaping open. ![]() If the wound is elsewhere on the body, call your doctor now. It does not matter how long it's been since sutures (or glue) were placed. The cut may need to be re-glued or re-stitched. If a face wound has re-opened, call your doctor now. General guidelines for re-suturing or re-gluing are listed below: For open cuts, call your child's doctor now.Sutures that come out early cause the most concern.The specific removal date depends on the location of the stitches or staples. ![]() They need to be removed within 4-14 days.Stitches and staples are used to keep wounds together during healing.When Sutures (Stitches) Should be Removed There is no cutoff, however, for treating open wounds. Ideally, they should be checked and closed within 6 hours. Any open wound that may need sutures should be seen as soon as possible.They usually need closure with sutures or skin glue. On the face, cuts longer than ¼ inch (6 mm) usually need to be seen.Cuts longer than ½ inch (12 mm) usually need sutures.Any cut that is split open or gaping needs sutures.When Sutures (Stitches) are Needed for Cuts Skin glue (Dermabond) questions are also covered.Stapled wounds are treated the same as sutured wounds.Rachel Liu, MD, is an assistant professor of emergency medicine at Yale University School of Medicine, Connecticut. Nibhanipudi, MD, is a professor of clinical emergency medicine at New York Medical College in Valhalla, New York. The child was given a cold compress to wrap around the finger and was discharged home without the need for wound repair, antibiotics, or a tetanus injection. No obvious cuts were noted, other than a small linear abrasion of the epidermis. There was a little swelling of the fingertip due to compression in the pencil sharpener ( Figure 3). Although the child initially cried, the pencil sharpener was removed quickly. The staff subsequently held the pencil sharpener steady and turned her finger counterclockwise. In contrast, a pencil (or finger) turned counterclockwise will roll against the unsharpened underside of the angled blade, so that the blade will not cut. When a pencil is turned clockwise, the blade will pare the wood. With a manual pencil sharpener, the pencil is inserted to the left of the blade and the blade is angled slightly downward. The child cried out during this process, and so this attempted method of removal was abandoned.Īfter thinking about the mechanics of a pencil sharpener, we reasoned that the child most likely felt pain when her finger was turned clockwise, or the pencil sharpener moved counterclockwise. The ED staff attempted to remove the other blade (the free blade) by loosening its screw, but that screw was too tight and could not be loosened. However, this attempt at removal had stripped the head off of the screw, and it now could not be loosened with a smaller screwdriver. The family had attempted to remove the blade by loosening the screw using the Phillips-head screwdriver included on the uncle’s Swiss Army knife. The administration of a digital nerve block was considered prior to removal however, it was felt that this would also be traumatic to the child and could possibly be avoided. The concern was that attempts to remove the blades would worsen any cuts she had received. Removal of the pencil sharpener from the girl’s finger initially posed a challenge because of the 2 entry ports and 2 blades evident on the underside (one on each side), without a clear indication of the direction of the blades’ rotation. ![]() The child was in no significant distress and appeared calm her vital signs were noncontributory. A slight amount of bleeding was present through the right-sided blade of the pencil sharpener, but the bleeding stopped soon after presentation. On physical examination of the girl, the pencil sharpener was found to have 2 entry ports, with the distal phalanx of her left index finger firmly wedged into the right-sided port. Her vaccinations were up to date, with a diphtheria-pertussis-tetanus booster having recently been administered. The child had a previous medical history significant for asthma, and she was taking albuterol as needed. She brought the child to the ED after her attempts to remove the pencil sharpener failed. The event was unwitnessed the toddler’s mother found the pencil sharpener stuck when she attended to her daughter’s crying. Prior to triage, the mother reported that the child had been playing with various toys including the pencil sharpener. A 2-year-old girl, accompanied by her mother and uncle, presented to the emergency department (ED) with the girl’s left index finger stuck in a medium-sized, square, manual pencil sharpener ( Figures 1 and 2).
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