Open Wound of the Hand

First aid for an open wound on the hand

1. Stop the bleeding. Press firmly on the wound with a clean cloth or gauze for 10 full minutes without peeking. Raise your hand above your heart. If blood soaks through, add more cloth on top rather than removing the first layer.
2. Wash your hands, then clean the wound. Rinse under clean running tap water for several minutes to flush out dirt. Wash the skin around it with soap, but avoid getting soap deep in the wound. Hydrogen peroxide, alcohol and iodine are not needed and can damage tissue.
3. Check what you can see and feel. Can you bend and straighten each finger at every joint? Is feeling normal on both sides of each fingertip? If not, the cut may have reached a tendon or nerve.
4. Cover it. Apply a thin layer of petroleum jelly or antibiotic ointment, then a non-stick dressing. Remove rings straight away, because the hand and fingers swell.
5. Decide if it needs closing. Wounds that gape or are deep heal far better if closed within about 6 to 8 hours (up to 12 to 24 hours for some clean wounds on well-supplied skin), so do not wait to see if it gets better.

Types of open hand wounds

Why location on the hand matters

• Palm and palm side of the fingers: the flexor tendons that bend the fingers and the digital nerves that supply feeling run close to the surface. A cut here that leaves a finger unable to bend at the tip, or numb on one side, needs a hand surgeon.
• Back of the hand: the skin is thin and the extensor tendons that straighten the fingers lie directly under it. An open wound on the back of the hand that leaves a finger drooping suggests a cut extensor tendon.
• Over a knuckle: a cut here may enter the joint. A wound on a knuckle from hitting someone in the mouth is treated as a human bite, which has a very high infection rate.
• Fingertip: see our page on open wounds of the finger and fingertip injuries.

When an open hand wound needs medical treatment

See a doctor, urgent care center or ER the same day if the wound:

• gapes open, or the edges do not come together easily
• is deeper than about 6 mm (1/4 in) or you can see fat (yellow), muscle (red) or white or gray tissue such as tendon at the base
• is longer than 1 to 2 cm, or jagged
• was caused by a bite, a rusty or dirty object, or glass that may still be inside
• is over a joint or a crease
• affects finger movement or feeling

Medical management of an open hand wound

A clinician will examine movement and feeling of each finger before giving any numbing injection, then:

• numb the area and explore the wound under good light, sometimes with a tourniquet to create a bloodless field
• irrigate it thoroughly with saline
• order an X-ray if glass, metal or a fracture is possible
• close it with stitches, skin glue or adhesive strips, or leave it open if it is a bite or heavily contaminated
• refer you to a hand surgeon if a tendon, nerve or artery is cut. Tendon repairs are usually done within days and need weeks of hand therapy afterward
• update your tetanus vaccination if needed
• prescribe antibiotics for bites, very dirty wounds, crush injuries and wounds in people with diabetes or poor circulation

Stitches on the hand usually stay in for 10 to 14 days, longer over joints.

Caring for a hand wound at home

• Keep the dressing clean and dry for the first 24 to 48 hours, then gently wash once a day and re-dress.
• Keep the wound moist with petroleum jelly under a dressing. Moist wounds heal faster with less scarring than wounds left to form a hard scab.
• Raise the hand to reduce swelling and throbbing, especially in the first 2 days.
• Move the uninjured fingers gently several times a day to prevent stiffness, unless told to rest them after a tendon repair.
• For pain, use acetaminophen (paracetamol) or ibuprofen at the label dose.
• Protect the healed scar from the sun for a year to reduce darkening.

Signs of infection

Check the wound daily. See a doctor promptly for:

• increasing pain, redness, swelling or warmth after the first 2 days
• pus or cloudy, smelly drainage
• red streaks spreading up the hand or arm
• swelling along a whole finger that is held slightly bent and hurts to straighten (possible tendon sheath infection, a surgical emergency)
• fever or feeling unwell

A gray, black or very pale base in an older wound can mean dead tissue or slough that slows healing and raises the risk of wound infection. Gray or white tissue at the bottom of a fresh deep cut may be tendon or bone. Both need assessment.

Complications

• Infection, including cellulitis, abscess, joint infection and bone infection
• Tendon injury, causing loss of finger bending or straightening
• Nerve injury, causing numbness and, if missed, permanent loss of feeling
• Stiffness and contracture from scarring across creases
• Retained foreign body, such as glass, causing ongoing pain or infection
• Tetanus, rare but serious, mainly after dirty or puncture wounds in people not up to date with vaccination

Frequently asked questions

How do I treat an open wound on my hand?

Press firmly for 10 minutes to stop bleeding, then rinse under clean running water and wash around it with soap. Check that every finger moves and feels normal. Apply petroleum jelly and a non-stick dressing, remove rings and raise the hand. Get medical care if the wound gapes, is deep, or affects movement or feeling.

Does an open wound on my hand need stitches?

It probably does if the edges gape, it is deeper than about 6 mm (1/4 in), longer than 1 to 2 cm, over a joint or crease, or keeps bleeding after 10 minutes of pressure. Get it closed within 6 to 8 hours for the best result. Bite wounds are often left open.

How long does an open hand wound take to heal?

A small cut usually closes in 7 to 14 days. Stitched wounds on the hand have stitches removed at about 10 to 14 days and keep strengthening for several months. Tendon repairs need 3 months or more of protected movement and therapy.

Why is my hand wound gray?

Gray or yellow-gray film on an older wound is often slough, a layer of dead cells and fibrin, which can slow healing and may need cleaning by a nurse or doctor. In a fresh, deep cut, white or gray tissue may be tendon. Either way, have it checked.

Do I need a tetanus shot for a cut on my hand?

You need a booster if the wound is dirty, a puncture or a bite and your last tetanus shot was more than 5 years ago, or if the wound is clean and minor and it has been more than 10 years. Get it within 48 hours if possible.