Oct 27, 2008 9:12 am US/Pacific
Dr. Mallika's Files: Case Of The Shattered Window
BOSTON (CBS) ―
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Mallika Marshall, M.D., shares experiences highlighting medical cases.
WBZ
Dr. Mallika Marshall is the medical reporter for CBS station WBZ-TV in Boston and a regular contributor to the CBS Early Show. Trained as both a pediatrician and internist, Marshall currently treats patients at an urgent care clinic near Boston. Names and identifiable characteristics of patients have been omitted or changed to protect patient privacy.
This Week's Case
A 42-year-old man came to clinic one evening reporting that he was trying to change an old window in his basement when the window shattered and cut his left hand. The injury happened yesterday morning. Instead of coming to the clinic at that time, he decided to wrap his hand in a rag and continue to work on his window project. Today, the wounds are still bleeding a little, and he thinks he may need stitches. He is not sure of the date of his last tetanus shot.
Cuts or lacerations are one of the most common reasons to seek medical attention in an urgent care clinic. It's true that minor cuts can be managed at home by washing them out with soap and water and applying a topical antibiotic cream and bandage. But more significant wounds need medical attention sooner rather than later. Examples of cuts that should be evaluated by a medical professional include:
- Long or deep cuts
- Animal or human bites
- Crush injuries
- Cuts that may involve a broken bone
- Cuts that could leave a noticeable scar
- Cuts that could still contain glass or metal
If you sustain a cut or laceration, keep the following in mind:
- If a cut needs to be repaired with stitches or sutures, it ideally should be done within 12 hours of the injury. Waiting longer than this increases the risk of wound infection. Many doctors will not repair a cut that is more than 12 hours old.
- If there's a possibility that glass or other material has been left inside the wound, the wound needs to be washed or irrigated by a medical professional before it closes.
- If the cut is due to an animal or human bite, you should be seen right away to prevent infection and assess the risk of rabies.
- If you have diabetes or another underlying medical condition that puts you at risk for infection, you should be evaluated.
- If you haven't had a tetanus shot in over 10 years, you are due for a booster and should be seen by a doctor.
Follow-up
The patient had an x-ray which showed small shards of glass embedded in his hand. The wounds were irrigated thoroughly and bandaged with antibiotic ointment, but could not be sutured because it had been more than 24 hours since the injury. He was given a tetanus booster which should last him another 10 years. He was told to return in 2 days for a recheck, and fortunately, the wounds were healing well at that time.
(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)
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