What is the treatment for a laceration to the left index finger with exposed tendon due to a table saw injury?

From the Guidelines

A table saw injury to the left index finger with exposed tendon requires immediate medical attention at an emergency room or urgent care facility. This is a serious injury that needs professional evaluation and treatment. First, apply direct pressure with a clean cloth or bandage to control bleeding, and elevate the hand above the level of the heart. Do not attempt to clean the wound deeply or apply antiseptics directly to the exposed tendon, as this could cause further damage. If possible, cover the wound with a sterile, moist dressing before seeking medical care. The exposed tendon indicates a deep laceration that likely requires surgical repair by a hand specialist. Without proper treatment, you risk permanent loss of finger function, infection, and other complications. The tendon connects muscle to bone and allows finger movement; damage to it can impair your ability to bend or straighten the finger.

According to the most recent and highest quality study available, 1, hospitalization is frequently necessary for wounds known or suspected to harbor superficial or deep infections, and surgical debridement of wounds has been common, but this may impair healing of the wound and lead to exposure of tendon and bone. Topical wound care should proceed while avoiding aggressive debridement that will excise healthy tissue and increase bone and tendon exposure.

Some key points to consider in the treatment of this injury include:

• Apply direct pressure to control bleeding and elevate the hand above the level of the heart
• Cover the wound with a sterile, moist dressing before seeking medical care
• Avoid cleaning the wound deeply or applying antiseptics directly to the exposed tendon
• Surgical repair by a hand specialist may be necessary
• Antibiotics, pain management, and physical therapy may be necessary after medical treatment
• Recovery from tendon injuries can take weeks to months, and following medical advice regarding wound care and rehabilitation exercises is crucial for optimal healing and restoration of function.

It's also important to note that, as stated in 1, wounds heal better with less infection if they are covered with an antibiotic ointment or cream and a clean occlusive dressing, but this should only be done if the wound is an abrasion or a superficial injury and only if the victim has no known allergies to the antibiotic.

In terms of specific treatment, the study 1 suggests that dermal substitutes, such as biodegradable temporizing matrix, a synthetic polyurethane dermal matrix, integrate rapidly into the wound and carry other benefits over natural skin. However, more information is needed about outcomes with xylazine-associated wounds and when drugs are injected into biodegradable temporizing matrix.

Overall, the key to treating a table saw injury to the left index finger with exposed tendon is to seek immediate medical attention and follow the advice of a medical professional regarding wound care and rehabilitation exercises.

From the Research

Table Saw Injury to Left Index Finger with Tendon Exposed

• The injury to the left index finger with tendon exposed is a serious lesion that can occur due to table saw accidents, as reported in a study of 130 cases of hand trauma from circular saw tables 2.
• In this study, 77% of cases involved two or more fingers being injured, and tip amputations of the left fingers were the most common type of injury, occurring in 49% of cases.
• Extensor tendon injuries were observed twice as often as flexor tendon injuries, highlighting the risk of tendon damage in table saw accidents 2.
• Another study found that table saw injuries can result in finger and thumb tendon, nerve, and vascular damage or amputation, with long-term outcomes including functional and sensory deficits 3.
• The application of SawStop technology, which stops the saw blade when contact with skin is made, can prevent serious injuries and reduce the risk of tendon exposure and other complications 3.

Epidemiology of Table Saw Injuries

• Table saw injuries are a common occurrence, with over 30,000 injuries occurring annually in the US, and fingers and hands being the most frequently injured body parts 3.
• A retrospective review of patients with power saw injuries found that 91% of patients were men, with an average age of 55 years, and that more experience with saw use does not necessarily protect against saw injuries 4.
• The study also found that 36% of patients had not received formal training on safe saw use, and 16% had removed a safety mechanism prior to the injury, highlighting the importance of proper training and safety precautions 4.

Treatment and Prevention of Table Saw Injuries

• Surgical treatment of table saw injuries may involve amputation, arthrodesis, reconstructive flap surgery, and spongy bone grafts, with joint stiffness being a common complication 2.
• Prevention of table saw injuries is crucial, and can be achieved through proper training, use of safety mechanisms, and regular maintenance of saw blades 3, 4.
• The use of antibiotics in the treatment of open fractures, including those resulting from table saw injuries, should be carefully considered, as the addition of an aminoglycoside to a cephalosporin may increase the risk of acute kidney injury without reducing the incidence of wound infection or hardware removal 5.