How to treat a bruised and bleeding fingernail

Feb 25, 2023 Source: Cainiu Health

Dr. Li Feng

Introduction

In general, subungual hematoma caused by trauma can be managed with disinfection, cold compress, observation, keeping the area clean, wound debridement, and medication. Additionally, if the nail becomes loose and the accumulated blood fails to resolve, leading to complications such as abscess formation or infection, incision and drainage should first be performed, followed by nail avulsion for treatment.

In general, when bleeding occurs under the fingernail due to trauma, improvement can be achieved through disinfection, cold compress, observation and maintaining cleanliness, wound debridement, and medication. Specific methods are analyzed as follows:

1. Disinfection

For nail injuries accompanied by bruising, timely disinfection of the wound is essential. As the nail grows, the bruising often resolves on its own. However, if symptoms continue to worsen, prompt medical attention is recommended.

2. Cold Compress

If bleeding is minimal, applying an ice pack within the first 24 hours after injury helps constrict blood vessels, reduce bleeding and fluid leakage, and prevent swelling. After 24 hours, a hot water bottle may be used to relieve congestion. Symptoms typically resolve in about two weeks.

3. Observation and Maintaining Cleanliness

Closely monitor the wound for signs of infection. Keep the injured area clean and dry, and change breathable bandages or adhesive dressings as needed to promote healing.

4. Wound Debridement

If the nail has become deformed or detached from the nail bed, and the area of subungual hematoma continues to expand, turns black, and is associated with significant swelling and pain, the nail may need to be removed. The local bleeding wound requires debridement: thoroughly rinse out debris such as dirt using normal saline, completely disinfect the wound with iodophor, and then suture or cover it with sterile gauze. A new nail typically regrows within approximately 2–3 months.

5. Medication

To prevent inflammation, patients should take oral anti-inflammatory medications under a doctor's guidance, such as amoxicillin capsules or penicillin V potassium tablets, to prevent wound infection.

In addition, if the nail becomes loose and the hematoma fails to resolve, leading to risks of abscess formation or infection, incision and drainage should be performed before proceeding with nail removal surgery.

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