Knuckle Infection - Friction Burn (basically)

[Defend]

I have a bit of a small knuckle problem at the moment - improper use of an improvised heavy bag (aka sand filled rice bag) yesterday led to several layers of skin on the knuckle of my right hand disappearing.

Shortly after finishing the workout I noticed a large amount of oozing. I flushed the wound, but no sterile water was available. This morning it was red and sore, about the same as when I went to bed. By late afternoon a yellow film had formed. I cleaned it again, this time with an alcohol wipe. The yellow film reappeared, and then grew into a bubble (see picture). I noticed when I took the picture there was still some foreign material in the wound, so I cleaned it out again. I meant to grab the alcohol wipe but grabbed Benzalkonium Chloride wipe instead - but regardless the foreign material is gone now.

If I was stateside I would just wait it out for a while and see what it does, but since I'm fairly remote and don't have quality medical care at my finger tips, I want to play it a little safer and make sure I'm doing what I should from the start.

Here are the immediate questions, and information that may be relevant to the question:

1) Should I cover the wound? I am in SE Asia, in a jungle environment.

2) How/How Often should I clean the wound? The water I have to work with is rain water. There is some purified drinking water (from what I can tell it is boiled and then put into coke bottles). I have Alcohol, Benzalkonium, and Iodine wipes in my kit. I grew up self-cleaning wounds with rubbing alcohol, so that one is my first instinct but I don't know if it is best.

3) Is there any other way I should be treating it? I did a search... ran across a conversation about leeches and maggots. Too bad i didn't have a finger transplant... I could change the leeches every day after a run. I have to pull 20 of those suckers off anyway. I can get a hold of Cipro, and there's always a chance of obtaining anything else if I know what to request.

Thanks for the help.

note: No formal medical or first aid training. Extent of knowledge is what I've figured out from trial and error self treating, growing up as a country boy. I'm willing to do pretty much anything that needs done myself, but not qualified to advise or treat anybody else.

- out

[The Reaper]

Not a medical professional, but I like to clean mine out immediately with betadine or peroxide early on, then follow up with a topical antibiotic like Neosporin.

Keep an eye out for redness or swelling. I had a nasty run in with cellulitis and it moves very quickly. MRSA is even worse.

Stay on it and seek professional medical attention immediately if you see any adverse changes.

You know what striking gloves are for?

TR

[FMF DOC]

With the environment your in I would clean it two or three times aday. Try not to use the rain water if you can help it. If your in a moist or humid environment I would keep it covered during the day and air it out at night.
Follow all the previous mentioned advice.

[Defend]

TR and FMF Doc, thanks for the advice. Will follow - I googled the two infections TR mentioned, and I'm going to avoid those. :eek:

You know what striking gloves are for?

I do now. I actually stopped part way through the workout when I started noticing blood spots on the bag, and wrapped my hands with boot socks (best wraps I had available) and continued. I didn't wrap soon enough - lesson learned the hard way.

The appearance has changed significantly over the last several hours, and the film is isolated to maybe 1/4 of the sore, the rest has turned red. There is a darker, crusty red ring around the perimeter. If it looks worse in the morning I'll update the photos for input.

-out

[Red Flag 1]

if it worth saying, it will be quoted.

[Defend]

Thanks all for the additional advice. RF1 PM with answers inbound.

I got it cleaned out this morning, but the film had hardened and attached itself to the flesh under it pretty well, so in order to get rid of it I ended up completely reopening the wound and it bled again. I have it covered now. I'll see if I can find some straight salt. I'm pretty sure they just use MSG here <g>.

-out

[Odd Job]

Watch out for redness extending up the back of the hand. I had a nasty experience in the 80s with a similar abrasion on my elbow. It developed into a painful red upper arm. It was a tasty lymphangitis and without the right antibiotics I would have been in a really sorry state of affairs indeed.
Not trying to scare you, just watch out for that symptom in particular. I wouldn't want anyone here to have it: for me it was a week I wish I had never experienced.

[Boomer-61]

Defend,
I'd go easy on the major septicides, they kill bugs but the can kill healthy tissue too. At this point I agree with the above, keep it clean with soap and water. Warm soaks are good too, if you don't get the salt solution, just soak it in warm soapy water. Watch for signs of deep infection: redness, stiffness, swelling, red streaks up your arm, lymph nodes at the elbow and or arm pit. If you have access to the topical ointments use them. Make sure you wash it out thoroughly between applications to get the old inactive ointment out of the way. Keep a dry dressing on it if possible. If it goes south, get medical aid quickly. Wounds on hands are a high priority. Keep us posted.

[Defend]

All, Thanks for the help.

I'm glad to report it's almost back to 100%. There's still a little bit of tenderness so I haven't gone back to full bag workouts (with wraps!) yet.
There is a new layer of healthy looking skin, no signs of complications.

I used iodine to clean it whenever it showed signs of infection after that was suggested. I had to reopen it a few times to clean out infection. I used rubbing alcohol those times, followed up a few hours later with iodine. I ended up soaking it in MSG once to keep from offending... Apparently in the local language "salt" and "MSG" are synonymous. That can't say anything good about my diet.

I also kept a double antibiotic ointment on it during the day when I had it covered for about 4 days. I didn't know to look for swollen lymph nodes - I haven't noticed any, but I'll log that one for future reference.

-out

[Ghostiger7]

I've also found that raw honey works well:cool: