From the Research
A through and through hand laceration requires immediate medical attention, and treatment should involve thorough cleaning, exploration, and suturing of the wound, as well as tetanus prophylaxis and antibiotics, to prevent infection and ensure optimal healing of hand structures, as supported by the most recent study 1.
Treatment Approach
Treatment typically involves:
- Thorough cleaning and irrigation of the wound
- Exploration to assess damage to underlying structures (tendons, nerves, blood vessels)
- Suturing of the wound, potentially in layers
- Tetanus prophylaxis if needed
- Antibiotics (e.g., Cephalexin 500 mg orally four times daily for 5-7 days)
- Pain management (e.g., Ibuprofen 400-600 mg orally every 6 hours as needed)
Follow-up Care
Follow-up care is crucial:
- Keep the wound clean and dry
- Change dressings daily
- Watch for signs of infection (increased pain, redness, swelling, fever)
- Follow up with a hand specialist within 3-5 days
- Begin gentle range of motion exercises as directed by your doctor
Rationale
The complex anatomy of the hand makes it prone to complications such as infection, loss of function, or permanent disability if not treated promptly and properly, as highlighted in a study on hand wounds 2. Additionally, a prospective multicentre cohort study found that delaying surgery for open hand injuries by 4 days does not appear to increase the risk of surgical site infection 3. However, the most recent study 1 suggests that initial ED management of open hand fractures results in reasonable infection rates and functional recovery, supporting the importance of prompt and proper treatment.