Surgicel Removal from Small Hand Wounds
Surgicel (oxidized cellulose) does not need to be actively removed from small hand wounds—it should be left in place to absorb naturally, as it is designed to be biodegradable and will resorb on its own over 1-4 weeks. 1
Key Management Principles
Leave Surgicel In Place
- Oxidized cellulose is specifically designed as a biodegradable hemostatic agent that absorbs naturally without requiring removal. 1
- The material will gradually dissolve and be absorbed by the body over several weeks as the wound heals. 1
- Attempting to remove Surgicel can disrupt clot formation, restart bleeding, and potentially introduce infection through unnecessary wound manipulation. 1
Wound Closure and Dressing
- After achieving hemostasis with Surgicel, proceed with standard wound closure if indicated (suturing can be completed up to 24 hours after trauma for most wounds). 2
- Cover the wound with a clean occlusive dressing to maintain moisture and prevent contamination. 3
- The wound can get wet within 24-48 hours after closure without increasing infection risk. 2
Important Caveats About Infection Risk
- While Surgicel is biodegradable, be aware that oxidized cellulose can promote infection if excessive amounts are used (>20mg in experimental models). 4
- In contaminated wounds, oxidized cellulose showed a 45% infection rate when 20mg was used with bacterial contamination, compared to 0% infection without hemostatic agents. 4
- However, smaller amounts (5-10mg) did not increase infection rates. 4
- For small hand wounds, the amount of Surgicel used is typically minimal, making infection risk from the material itself low.
Monitoring for Complications
- Follow up within 24 hours by phone or office visit to assess for signs of infection. 5
- Watch for increasing pain, redness, swelling, warmth, or purulent discharge—these indicate wound infection requiring treatment. 3
- Hand wounds have higher infection rates than other locations and warrant closer monitoring. 6
When Antibiotics Are NOT Routinely Needed
- Prophylactic antibiotics are not recommended for simple hand lacerations that are properly irrigated and debrided. 1, 2
- Antibiotics should only be considered if there is >5cm of erythema, temperature >38.5°C, or signs of established infection. 1
- The most important infection prevention measure is thorough irrigation with copious amounts of water or sterile saline, not antibiotics. 3, 2