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PPE

Don’t be so fast to shrug off “minor” cuts & punctures

An annoying little cut?

By Dave Johnson
ISHN0717_F9_pic.jpg
July 1, 2017

You've seen plenty of occupational injury stats, here is one that's startling: In 2012, workers suffered 186,830 nonfatal injuries to the hands and wrists serious enough to warrant days away from work, according to the U.S. Bureau of Labor Statistics. That's 511 hand and wrist-related lost-time injuries every day of the year. This alone is enough to ensure you have a robust hand protection program.

Many of these serious hand and wrist injuries involve fractures, amputations, burns, carpal tunnel syndrome and tendinitis. But in 2014, BLS reports there were approximately 100,000 cuts, lacerations and punctures. These are the most likely everyday injuries to the hands- many times incurred by workers not wearing gloves. Many will require on-site first aid treatment and the worker goes back to the job. But think about it: Many more minor nicks, cuts and punctures to the hands will go unreported. Workers shake it off, maybe self-treat and put a bandage on the wound, thinking little of it.

A very close call

But consider the story of Chris Aldred, an IT specialist in Great Britain who cut his finger moving a computer, as reported in the London newspaper the Daily Mail. He didn't give it a second thought. He said he had worse cuts from opening an envelope. But two weeks after his cut he felt a sharp twinge in his lower back. He also had a high temperature, felt hot and shivery, and had aches and pains - he assumed it was the flu. Three days later, Chris tried to get up to go to the bathroom in the middle of the night but was unable to move his legs. He was terrified.

An MRI scan revealed an eight-inch mass on his spine. The mass was an abscess. Doctors explained that Staphylococcus aureus bacterium, known for causing infections, had entered his body via a recent wound or cut. Doctors drained the abscess during surgery. It relieved the pressure on his spinal cord, but Chris remained paralyzed. It wasn't clear if long-term damage had been caused. He was put on intravenous antibiotics to fight the remaining infection. Three days later, he felt confused, couldn't stop shaking, and was sweating so much his bed sheets had to be changed. He had developed sepsis, caused when the body overreacts to an infection - his abscess. Sepsis attacks organs and tissues, causing a life-threatening drop in blood pressure and organ failure.

Every year, severe sepsis strikes more than one million Americans, according to the National Institute of General Medical Sciences. It's estimated between 28 and 50 percent of these people die.

After five days of antibiotics, the infection was brought under control. Doctors warned of a slow recovery and couldn't say if Chris would walk again. Within three weeks of his operation, he could wriggle his toes. With physiotherapy, he rehabbed slowly and was able to walk unaided five months after falling ill. Eighteen months after cutting his finger, Chris finally returned to work.

Injury or infection to a finger or fingers is a common problem, according to WebMD. Infection can range from mild to potentially serious. Often, infections start out small and are relatively easy to treat. But failure to properly treat these infections can result in permanent disability or loss of the finger- or in Chris Aldred's case, something much worse.

Signs & symptoms of infection

Your workers should know that early recognition and proper treatment of finger cuts and punctures that become infected will help prevent most of the serious outcomes. Most infections are caused by bacteria. Symptoms vary widely. A burning or itching sensation may be present. There may be mild swelling. There also may be open wounds in the area affected occurring in clusters after the formation of a small blister-like lesion. The fluid in these lesions is usually clear in appearance but may be slightly cloudy. You may also have a low-grade fever and have swollen and tender lymph nodes in the area, according to WebMD.

If the motion of the fingers and hand is painful or difficult, this may indicate a deep space infection of some type. A deep space infection that arises in the web space of the fingers is also called a collar button abscess. The space between the fingers will be painful and swollen. The area may also be red and warm to the touch. As the abscess becomes larger, the fingers will be slightly spread apart by the increasing pressure. The central area may have a soft spot that represents a collection of pus under the skin, according to WebMD.

Don’t wait to see a doc

If any signs and symptoms are present, you should contact your doctor at once, according to WebMD. If you have signs or symptoms of a superficial infection or deep space infection, you should seek emergency care at once.

Another medical source, MedicineNet.com, which is reviewed by physicians, says if the wound begins to drain yellow or greenish fluid (pus), or if the skin around the wound becomes red, warm, swollen, or increasingly painful, a wound infection may be present and medical care should be sought. Any red streaking of the skin around the wound may indicate an infection in the system that drains fluid from the tissues, called the lymph system. This infection can be serious, especially if it is accompanied by a fever. Prompt medical care should be sought if streaking redness from a wound is noticed, according to MedicineNet.com

This medical source also states if you cannot control the bleeding from a cut or scrape (abrasion), seek medical attention. Any cut that goes beyond the top layer of skin or is deep enough to see into might need stitches, and should be seen by a doctor as soon as possible. Generally, the sooner the wound is sutured, the lower the risk of infection. Ideally, wounds should be repaired within six hours of the injury, according to MedicineNet.com

Puncture wounds do not usually bleed much, but treatment is necessary to prevent infection. A puncture wound can cause infection because it forces bacteria and debris deep into the tissue, and the wound closes quickly, forming an ideal place for bacteria to grow, according to MedicineNet.com

If and when you see a doctor, be ready to answer these questions, according to WebMD:

  • How did the injury or infection start?
  • When did this first occur or begin?
  • Where did it occur? Home? Work? In water? In dirt? From an animal or human bite?
  • Is it possible that a foreign body is in the wound?
  • What have you done to care for this before seeing your doctor?
  • When was your last tetanus shot?
  • Any previous injuries to the area?
  • Any other medical problems that you may have not mentioned?
KEYWORDS: Hand Protection infection prevention work glove innovations

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Dave Johnson was chief editor of ISHN from 1980 until early 2020. He uses his decades of expertise to write on hot topics and current events in the world of safety. He also writes and edits at Dave Johnson’s Writing Shop LLC and is editor-at-large for ISHN. Find him at https://www.facebook.com/Dave-Johnsons-Writing-Shop-101316571547263/, and on LinkedIn at https://www.linkedin.com/in/daveljohnsoneditor/.

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