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Suggest Treatment For Soft Tissues Infection Caused By A Cut

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Posted on Tue, 27 Jan 2015
Question: Two days ago I cut my finger pretty badly in my kitchen and went to the ER and had to have 12 stiches. I also had a tetnus shot. The day after, I woke up with itchy swollen hands and today, I am still experiencing this. What could it be?
doctor
Answered by Dr. Grzegorz Stanko (1 hour later)
Brief Answer:
Soft tissues infection caused by the cut.

Detailed Answer:
Hello!

Thank you for the query.

Can you please attach a photo of the wound and the photo of both hands. It will be much easier to give precise answer.
What was the cut made with? Was it a knife? Was this knife clean or dirty with meat? Did you get any antibiotic for it? Does your hand hurt?

Symptoms like swelling and itching usually indicate an infection. Many cuts which do look fine right after the stitches are placed, become swollen after a day or two. Its because a bacteria need some time to spread from a cut to other soft tissues. This happens very often if a cut is made with kitchen knife dirty with meat. That is why it is good to leave some breaks between the stitches (so the wound is partially open) and give antibiotic (like Clindamycine 300 mg 3 times a day).
The other symptoms of infection which should be present are pain and pulsating (especially when sleeping).
Benedryl gel and Cortisone cream usage is pointless. This agents do not work for wound infection and do not accelerate the healing. Moreover, using them can worsen the wound condition.

This is the best answer I can give without pictures.

Hope this will help. Feel free to ask further questions.
Regards.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Grzegorz Stanko (6 hours later)
Thanks for your response but the wound is definitely not infected. There is no redness or swelling around the stiches. The Emergency Room doctors applied an antibiotic infused gauze directly to the wound before dressing it with sterile gauze bandage. Also, 24 hours later, I changed the dressing and the stiches looked nice and flat with no redness, swelling, pain or puss around the wound or stiches. I also applied an antibiotic before redressing it. I would send a picture, however, I just finished changing the dressing a few minutes ago for the second time. Again there is no sign of infection around the wound or stiches today. I once again applied an antibiotic and a waterproof bandage.

While waiting for a response I continue to research possible causes of itching and swelling. At this point, I think the most likely cause is an allergic reaction to either the local anesthetic or some ingredient in the tetanus vaccine. Most likely angioedema, but due to holiday schedule, I can't reach my physician to confirm or consult. Benedryl gel gives some relief.
doctor
Answered by Dr. Grzegorz Stanko (13 hours later)
Brief Answer:
Allergic reaction is a one possibility.

Detailed Answer:
I am not saying that the wound is infected. I am just saying that the wound or better the cut is a source of infection. Wound is just a superficial view. You can not see how deep it is and if the deeper structures like tendons, muscles are not affected.

You haven`t answered my questions about the wound (what was it made with?) and I can not see how it looks like. So its really hard to talk about the cause. I can not compare both hands to see if one is more swollen than the other one.

Of course, it might be an allergic reaction. Its impossible to tell what has caused it. Tetanus shot could cause it, but please note that allergic reaction gives rash as a first symptom. Such rash usually appears on the whole body (chest, back, neck, face mostly).

Applying antibiotic on the skin does not help with healing. It is proven that an antibiotics applied on the skin have no antibacterial effect.

Hope this will help.
Regards.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
Answered by
Dr.
Dr. Grzegorz Stanko

General Surgeon

Practicing since :2008

Answered : 5795 Questions

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Suggest Treatment For Soft Tissues Infection Caused By A Cut

Brief Answer: Soft tissues infection caused by the cut. Detailed Answer: Hello! Thank you for the query. Can you please attach a photo of the wound and the photo of both hands. It will be much easier to give precise answer. What was the cut made with? Was it a knife? Was this knife clean or dirty with meat? Did you get any antibiotic for it? Does your hand hurt? Symptoms like swelling and itching usually indicate an infection. Many cuts which do look fine right after the stitches are placed, become swollen after a day or two. Its because a bacteria need some time to spread from a cut to other soft tissues. This happens very often if a cut is made with kitchen knife dirty with meat. That is why it is good to leave some breaks between the stitches (so the wound is partially open) and give antibiotic (like Clindamycine 300 mg 3 times a day). The other symptoms of infection which should be present are pain and pulsating (especially when sleeping). Benedryl gel and Cortisone cream usage is pointless. This agents do not work for wound infection and do not accelerate the healing. Moreover, using them can worsen the wound condition. This is the best answer I can give without pictures. Hope this will help. Feel free to ask further questions. Regards.