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Why Doctors May Not Always Try to Save a Fingertip

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I'm Alex Villarreal with the VOA Special English Health Report, from http://voaspecialenglish.com | http://facebook.com/voalearningenglishWe started talking last week about how to decide if a common injury -- a bleeding cut on a finger -- requires medical attention. If the bleeding stops when you press on it for a few minutes, then you probably do not need a doctor. But if the injury is more serious, then you could suffer permanentdamage unless you get help. Dr. Martin Brown is chairman of emergency medicine at Inova Alexandria Hospital in Virginia. He says injuries that damage a "deep structure" like a bone, tendon or nerve should always be treated by a doctor. Forceful bleeding and bright red blood are dangerous signs of adeep cut. Dr. Brown says there are different medical products that can help stop the bleeding. One example is Gelfoam. He said Gelfoam is a cellulose product that promotes the clotting of blood by giving blood a surface upon which to clot.The traditional way to close a serious cut is with sutures, also known as stitches. A needle and nylon thread are used to sew the edges of the wound together.But Dr. Brown says a more recent development is a medical glue. He said the glue is a medical kind of "super glue." Super glue makes many things stick together. But Dr. Brown says people should not use it on injuries. He says the medical glue can be used when a cut is straight and comes together easily. The American Academy of Orthopaedic Surgeons has advice on its website about what to do if a fingertip is not just cut but cut off. First, gently clean the amputated part with water or saline. Dr. Brown says people can use a saline cleaner for contact lenses. Saline contains salt. Next, without drying the fingertip, cover the part in gauze or a cloth. Place it in a waterproof bag and place the bag on ice. Do not put the amputated part itself directly on ice. That could damage it more.Bring thefingertip to a hospital as quickly as possible. A surgeon may try to reattach a fingertip that is cut off below the first joint. But Dr. Brown says fingertips are not often reattached if they are the length of a fingernail or shorter. He says a reattachment operation can take many hours.It is doneunder a microscope, reattaching nerves and arteries and tendons.Even then, he says, the result will not necessarily be better than losing part of a finger. Dr. Brown says patients must also be willing to undergo a rehabilitation process to regain use of the finger. For VOA Special English I'm Alex Villarreal.

(Adapted from a radio program broadcast 02Feb2011)
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