I only wrapped my finger twice around before cutting and taping the roll. I didn't use very much of it, as it was thicker and stiffer-it actually kept me from accidentally bending my finger and ripping the stitches out-than the gauze roll the doctor used. I couldn't find the exact gauze roll that the doctor used, so I purchased a Johnson & Johnson one that gripped itself. After 48 HoursĪfter the first 48 hours, she said I should remove the dressing, wash the stitches and wound gently, lightly pat dry, apply Neosporin, place a clean gauze pad (she gave me several large Curad pads, which I cut to fit the wound), and then wrap gently (and not too firmly) with a gauze roll.
If I wanted to take a shower before then, I could place my hand in a plastic bag to keep it dry. She told me to keep my finger elevated above my heart (to reduce swelling), and asked me to refrain from washing it for 48 hours. Seven of them.Īfter she finished stitching the cut, she applied an antibacterial ointment, a gauze pad, and then wrapped my finger firmly in gauze and taped the end. Because the cut was deep and along the joint, I required stitches. It had not stopped bleeding, and she explained that had I not come in tonight, I would have realized that I needed to come in the next morning, as I would still have been bleeding. Thankfully, I did not sever the tendon and did not need surgery. She had me move my finger in a few different directions and bend it. And then he left the room and I waited some more.įinally the physician came in and removed my finger from the bath. He carefully unwrapped my bandages, studied the cut, and placed my finger in a bowl of disinfectant. I was shown to a room, had my vitals taken, confirmed that I had a recent tetanus shot, and someone came to examine my wound. Did she not realize I might only have six hours?! After taking my insurance information and credit card, she told me to wait. We arrived a few minutes before closing, and the receptionist did not seem to have the sense of "urgency" one would expect from an "Urgent" Care facility. It was closing in 15 minutes (this happened on a Saturday night) and wasn't open on Sunday, and I wasn't going to lose the six hour window, in case I had cut through a nerve or tendon and needed surgery. That was enough for me: I asked my husband to drive me to Urgent Care.
In one of the articles I found, it said that if you cut through a tendon or certain nerves and have to have surgery, and it should be done within six hours of the cut. I researched deep finger cuts on the internet and started to self-diagnose myself (I do not recommend this: go to a professional). It first felt tingly, like when your arm or foot falls asleep and sensation begins to return. He wrapped and taped my finger as tightly as he could, and I thought that was it.īut soon after, I started to lose sensation in my finger. He placed a paper towel over it and told me to hold it firmly he then ran upstairs for gauze, bandages, and tape. It is of note that small studies indicate that short-term immunosuppression with mycophenolate and rapamycin may alleviate or prevent this problem.3 Will it be possible to escalate AAV vector dosing to achieve higher factor IX levels? This will require careful escalation of vector dose in future clinical trials.He isn't bothered by blood and examined the cut. Will there be an immune response to AAV? The answer to this question will require prospective assessment with careful monitoring of liver function tests to detect the transient transaminitis that may accompany exposure to some AAV vectors. For humans, the critical steps will be to analyze any potential integration sites in the human genome in addition to intron 1 of the F9 gene. Will this approach be safe? Dog studies, followed by careful phase I clinical trials in humans, would be required to answer this question. If it resulted in similar levels in man, this would also prevent spontaneous bleeding, which accounts for the major morbidity of the disease. Is ZFN-directed genome editing of a mutated F9 gene sufficient to result in normal hemostasis? In the mouse model, this approach achieved a factor IX level high enough to prevent spontaneous bleeding.
So, is this approach ready for use in humans? Unlike vector-based gene therapies currently under clinical investigation, ZFN-directed gene editing would produce a permanent correction after a single treatment (presumably intravenous in humans rather than the intraperitoneal route used in mice) and if proven safe and effective in dogs and in phase I/II trials in humans, it might be a potential approach.
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