First aid and treatment for a cut or severed finger

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If a person has severed their finger, it is important that they see a medical professional as soon as possible.

The American Academy of Orthopaedic Surgeons (AAOS) note that while the person is preparing to see a doctor, someone else should administer careful first aid.

The sections below will look at first aid for a severed finger in more detail.

Dealing with the injury

After the initial injury, someone should apply firm pressure to the bleeding area and:

1. Carefully clean the amputated area with water or a sterile saline solution.
2. Gently cover the area in a moist gauze wrap.
3. Elevate the injured hand to reduce swelling.
4. Keep the affected hand steady with a short splint.

Caring for the severed finger

If the fingertip or finger is completely detached from the hand, someone should:

1. Wrap the amputated part in a damp paper towel and place it in a sealed, watertight bag or container.
2. Put the sealed bag into another sealed container on ice. Do not allow the severed part of the finger to touch the ice directly, as this could further damage it.
3. Take the amputated part to the emergency room. There, a healthcare professional can treat the wound and may be able to reattach the severed part of the finger.

Dealing with shock

Shock occurs when the body’s cells do not receive enough oxygen-rich blood as a result of an illness or injury.

A person may experience shock after severing a finger.

Symptoms of shock may include:

• fainting
• rapid and shallow breathing
• pale, cold, or clammy skin
• excessive sweating
• a fast heart rate
• nausea or vomiting
• enlarged pupils
• thirst
• sweating
• sighing

To assist someone who may be experiencing shock:

1. Call 911.
2. Avoid giving the person anything to eat or drink.
3. Help the person lie down and elevate their feet.
4. Use a blanket or coat to help keep them warm.
5. Turn them on their side if they are vomiting.
6. Provide comfort and reassurance.
7. Monitor their breathing and pulse.

If they stop breathing, a person should perform cardiopulmonary resuscitation (CPR).

Learn more about how to perform CPR here.

Healthcare professionals will treat shock differently depending on the underlying cause.

A healthcare professional may administer a numbing injection and wash the affected area with a saline solution.

They will examine the finger for missing tissue or exposed bone and remove contaminants and dead tissue. This procedure is called debridement, according to the AAOS.

The healthcare professional may order X-rays if they suspect broken bones, and they may prescribe an antibiotic or provide a tetanus shot.

They will treat the amputated or damaged area of the finger depending on the severity of the injury.

The sections below will look at some treatment options depending on the severity of the injury.

Minor tissue injury

If there is no exposed bone, a healthcare professional may place a dressing over the injury and prescribe cleaning solutions and range-of-motion exercises.

If the injury is a simple cut or laceration, they will likely place stitches to close the wound.

The AAOS note that after 24–48 hours, a person may need to soak the finger in warm, soapy water or saline solution once per day.

They can usually start the range-of-motion exercises after 48 hours.

Recovery time is in the range of 2–4 weeks.

Larger tissue injury

In some cases, the healthcare professional will leave the wound open to heal gradually on its own.

In other cases, a person may require surgical intervention:

Skin grafting

A healthcare professional will take an area of skin from the person’s forearm or outer area of the hand and graft it onto the injured area.

They will then stitch the donor area and the wound closed.

Reconstructive flap surgery

Skin grafts may not be suitable for more severe tissue injuries.

The healthcare professional may move a full-thickness flap of skin — containing fat, blood vessels, and healthy skin — from the person’s hand and use it to cover the wounded area.

Exposed bone

If the bone is exposed, a person may require reconstructive flap surgery.

A surgeon may also suggest exposed bone shortening. This is when they shorten the bone slightly so that they can stitch the wound closed.

The person will retain the ability to use their injured finger.

If a person has lost a large portion of their finger, a surgeon may decide to reattach the amputated part.

Replantation is a complex surgical procedure that involves repairing the blood vessels to allow proper blood flow to and from the severed part. This surgery involves significant recovery time.

However, it is worth noting that surgeons cannot reattach every amputated finger. Depending on how the injury occurred, the tissue may be too damaged to successfully replant. This might be the case with crush injuries, for example.

What happens if the surgeon cannot reattach the finger?

If the surgeon is unable to perform or advises against replantation, they will prescribe medications to assist with the pain and may suggest some hand exercises.

The person may require orthotics, such as supports or braces, and they may need to apply heat or ice to the injury while it is healing.

For those under the age of 6 years old, a surgeon will clean and prepare the amputated finger. They may decide to reattach it.

However, it is possible for the fingertip to grow normally, even if there was exposed bone.

Treatment will depend on:

• the age of the child
• the health of the child
• the condition of the amputated finger part
• how the injury happened

A severed finger injury may take several months to heal, after which point a person may still experience mild-to-severe pain and cold sensitivity for up to a year (or sometimes permanently).

The person may require pain medications as well as physical therapy.

Physical therapy

A healthcare professional such as a physiotherapist or specialized hand therapist may recommend exercises to improve range of motion and strengthen the affected hand and fingers.

They may also suggest additional therapies, including:

• using compression wraps to reduce swelling
• wearing a splint
• applying heat and ice
• performing massage
• receiving electrical stimulation to the nerves in the hand

Nerve damage

The American Society for Surgery of the Hand note that a person may experience symptoms associated with severed nerves following an amputated finger. These may include phantom or abnormal sensations, pain, and cold sensitivity.

A neuroma, which is an enlarged nerve end, can also occur. This can cause severe pain in a small area.

If the person’s symptoms are debilitating, they may require further surgery.

Surgery will improve feeling and functionality in the finger. However, certain complications are associated with the injury itself and with fingertip surgery.

Some potential complications include:

• hypersensitivity
• numbness
• a neuroma
• stiffness
• infection
• loss of function in the reattached part

A person should contact a doctor following surgery on the injured finger if they experience severe pain. This may indicate a neuroma.

They should also seek medical attention if they experience any symptoms of infection, such as:

• increasing tenderness
• flushing and swelling of the wound
• increasing pain
• chills and shaking
• leaking from the wound
• persistent fever

If a finger is severed, someone should immediately administer first aid and store the finger in an airtight container inside another container with ice. The severed part of the finger should never come into direct contact with the ice.

A person should then receive medical attention. A healthcare professional will assess the wound and decide if surgery is necessary and if the finger is suitable for replantation.

Recovery can take several months and may include physical therapy and pain management. Nerve damage is a possibility, and this may require further surgery.

A person should contact a doctor following surgery if they experience severe pain or notice any symptoms of infection.