Hand Injuries: When to See a Plastic Surgeon Urgently

Why the Hand Is So Delicate

In a very small space, the hand packs together:
• Tendons, which bend and straighten the fingers
• Nerves, which give feeling and control small muscles
• Blood vessels, which keep the fingers alive
• Bones and joints, which give structure and movement
• Thin skin, which has little padding over these structures
Because everything lies so close to the surface, even a shallow-looking wound can damage several
of these structures at once.

Common Causes of Hand Injuries

• Kitchen accidents, such as knife cuts
• Broken glass, especially from windows or doors
• Machinery and workshop tools, including grinders, saws, and presses
• Road accidents
• Door and car-door crush injuries
• Firecrackers and burns
• Falls onto an outstretched hand
• Animal bites

Emergency Signs: See a Doctor Straight Away

Go to a hospital with a plastic or hand surgeon immediately if you have:
• A deep cut that gapes open or shows yellow fat, tendon or bone
• Numbness or tingling in a finger after an injury
• Inability to bend or straighten a finger or the thumb
• A finger that looks pale, white, blue or cold after injury
• Heavy bleeding that doesn’t stop with pressure
• A partly or fully cut-off finger, thumb or hand
• A crush injury with severe swelling, a deformed shape or a lot of pain
• A deep cut from a machine, a dirty wound or a bite, which can get infected quickly
• Signs of infection, such as spreading redness, swelling, pus, fever or throbbing pain
If you are unsure, it is safer to be seen. Some injuries, such as a divided tendon or nerve, do not look
dramatic at first.

First Aid: What to Do Right Now

1. Stay calm and control the bleeding. Press firmly on the wound with a clean cloth or gauze.
Keep pressing and raise the hand above heart level. Don’t keep lifting the cloth to check.
2. Remove rings, watches, and bracelets right away, before swelling makes it impossible. If you
can’t remove a ring, tell the doctors.
3. Cover the wound with a clean, dry cloth or sterile dressing. Don’t scrub it hard or apply powders,
creams, turmeric, oil or home remedies.
4. Don’t pull out anything deeply stuck in the wound. Leave it in place, support it and go to
hospital.
5. Keep the hand raised and still. A pillow or sling can help.
6. Don’t eat or drink if you may need surgery, because doctors may need you to have an empty
stomach for anaesthesia.
7. Go to hospital immediately. Ask someone else to drive you. Don’t drive yourself with a badly
injured hand.
A tourniquet is a last resort. Use one only for severe bleeding that threatens life and cannot be
controlled by firm pressure. Note the time it was applied and tell the doctors.

Why Early Treatment Matters

• Tendons and nerves repair better when treated early, and delay can make surgery harder.
• Blood supply to a damaged finger can fail quickly, and a cut-off part can survive only for a limited
time.
• Infection can spread rapidly in the closed spaces of the hand and may cause stiffness or lasting
damage.
• Stiffness and scarring can develop if wounds are not treated and moved correctly.

Recovery and Rehabilitation

Surgery is only the first step. Good recovery depends on what happens afterwards:
• Follow the splint and dressing instructions exactly, and keep the hand raised to reduce
swelling.
• Attend hand therapy or physiotherapy. Therapists guide gentle exercises that prevent stiffness
and help tendons glide.
• Be patient with nerves. Feeling returns slowly, and it may take months.
• Don’t start using the hand too early or return to heavy work until your surgeon says it is safe.
• Keep follow-up appointments so the team can adjust your plan.

Preventing Hand Injuries

• Use guards, and never bypass safety features on machines.
• Wear gloves and protective equipment in workshops and factories.
• Don’t use machinery when tired or distracted.
• Use cut-resistant gloves and a stable cutting board in the kitchen.
• Keep children away from doors, machinery and firecrackers.
• Handle glass carefully and clear broken pieces with care.

Hand Injury Care in Thrissur with Dr. Jyoshid R. Balan

Dr. Jyoshid R. Balan is a plastic and reconstructive surgeon at Sushrutha Institute of Plastic Surgery,
Elite Mission Hospital, Thrissur. His practice includes hand surgery, nerve repair, and microvascular
surgery, and he treats injuries as well as problems from earlier injuries. Patients have described the
surgery and recovery care as giving them a second chance at life.
For a fresh injury, go to the hospital straight away. For stiffness, numbness, or a hand that never
recovered well after an earlier injury, book a consultation at drjosh.in/contact or call +91 8113005557