From the Guidelines
For a thumb laceration repaired with tissue adhesive and a finger splint, the patient should keep the wound clean and dry for 24-48 hours, then shower gently without rubbing, and avoid soaking the wound in water for 7-10 days. The provided evidence does not directly address the discharge instructions for a patient with a thumb laceration repaired with tissue adhesive and a finger splint 1. However, general principles of wound care can be applied. After the initial 24-48 hours, the patient may shower but should gently pat the area dry without rubbing. It is essential to avoid soaking the wound in water (no swimming, baths, or dishwashing) for 7-10 days until the adhesive naturally falls off. The splint should be left in place as directed, typically for 7-10 days, to protect the repair and limit movement that could reopen the wound. For pain management, the patient can take acetaminophen (Tylenol) 650mg every 6 hours or ibuprofen (Motrin/Advil) 400-600mg every 6 hours as needed, unless contraindicated. The patient should watch for signs of infection, including increasing redness, warmth, swelling, pus, fever, or worsening pain. Key points to emphasize include:
- Keeping the wound clean and dry
- Avoiding water immersion
- Managing pain as needed
- Monitoring for signs of infection
- Following up with a healthcare provider if concerns arise, such as the wound reopening or signs of infection. Given the potential risks associated with splinting, as mentioned in the evidence 1, such as increasing attention and focus to the area, exacerbating symptoms, and potential for muscle deconditioning, it is crucial to balance the benefits of splinting with these potential harms and consider alternative strategies that encourage normal movement patterns and resting postures.
From the Research
Discharge Instructions for Thumb Laceration Repaired with Tissue Adhesive and Finger Splint
- The patient should keep the wound dry and clean to promote healing and prevent infection 2.
- The finger splint should be worn as instructed to immobilize the thumb and allow the wound to heal 3, 4.
- The patient should be advised to avoid submerging the wound in water, such as taking a bath or swimming, until the wound is fully healed 2.
- The patient should be instructed on how to change the dressing and apply a new one if necessary, using occlusive or semiocclusive dressings to promote a moist environment for wound healing 2.
- The patient should be advised to monitor the wound for signs of infection, such as redness, swelling, or increased pain, and to seek medical attention if any of these symptoms occur 2.
- The patient should be instructed to follow up with their healthcare provider to have the splint removed and the wound checked for proper healing 2, 4.
- Tetanus prophylaxis should be provided if indicated, based on the patient's vaccination history and the type of wound 2.
- The patient should be advised to avoid heavy use or bending of the thumb until the wound is fully healed to prevent disruption of the tissue adhesive 2.