From the Guidelines
For skin torn off between your thumb and finger after rock climbing, clean the wound immediately with mild soap and water to prevent infection, and apply antibiotic ointment such as Neosporin or Polysporin to the wound before bandaging to prevent infection, as recommended by the most recent guidelines 1. The wound should be thoroughly irrigated with a large volume of warm or room temperature potable water with or without soap until there is no foreign matter in the wound, as suggested by the American Heart Association and American Red Cross guidelines 1. It is also important to cover the wound with a clean occlusive dressing and/or a topical antibiotic that keeps the wound moist and prevents drying, as recommended by the 2010 American Heart Association and American Red Cross International Consensus on First Aid Science with Treatment Recommendations 1. For pain relief, take over-the-counter medications like acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed. Some key points to consider in the management of this type of injury include:
- Keeping the wound moist with ointment to promote healing and minimize scarring
- Changing the dressing daily or when it becomes wet or dirty
- Seeking medical attention if you notice signs of infection (increasing redness, warmth, swelling, pus, or red streaks), if the wound is very deep or large, or if you haven't had a tetanus shot in the past 5 years
- Considering the risk of infection and the need for antibiotic treatment, especially in fresh, deep wounds and wounds in certain critical bodily areas, such as the hands, as recommended by the 2018 WSES/SIS-E Consensus Conference 1.
From the FDA Drug Label
Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage children under 2 years of age: ask a doctor
The treatment for an avulsion injury between the thumb and finger, likely caused by rock climbing, may involve:
- Cleaning the affected area
- Applying a topical antibiotic ointment, such as Bacitracin, 1 to 3 times daily
- Covering the area with a sterile bandage 2
From the Research
Avulsion Injury Treatment
The treatment for an avulsion injury, where the skin is torn off, between the thumb and finger, likely caused by rock climbing, is not directly addressed in the provided studies. However, the studies do discuss various hand and finger injuries common in rock climbing.
Common Injuries in Rock Climbing
- Finger tendon injuries are the most common injury, followed by abrasions/lacerations and fractures 3
- Pulley injuries occur in up to 20% of climbers, with the A2 pulley of the ring finger being the most frequently injured 4
- Finger flexor pulley system injuries are the most common overuse injury in rock climbers 5
Treatment for Pulley Injuries
- Most pulley injuries can be successfully treated with a week of immobilization, followed by a range of motion (ROM) exercises for one week 4
- Conservative treatment, including immobilization, the H-tape method, and the use of a protective pulley splint, is recommended for grade I to III pulley injuries 5
- Surgical repair is reserved for grade IV injuries that are not amenable to conservative treatment 5
Diagnosis and Imaging
- Ultrasound and MRI are the current modalities best suited for confirming clinical findings of pulley injuries 4
- Ultrasound is highly sensitive and specific for diagnosis and is recommended as the initial imaging technique of choice 5
- Magnetic resonance imaging is recommended as an additional imaging study if ultrasound is inconclusive 5