It never ceases to amaze me how the body functions so efficiently. From everyday living, to trauma, then the process of healing!!!!! Wow! All of our trillions of cells that are parts of systems, working harmoniously almost always.............that's an understatement. lol Thanks Doc for allowing us to look in!
Great work Sir. I had to do this on myself! I used an elastic band to make it go numb and then use my leatherman multitool to drain and remove thorn. Lots of iodine was my saving grace and dressing changed every day. Bit of thorn was 3/4" long! ,very nasty. Healed perfectly thank God!
Boy that's a huge thumb!! Poor guy that must have hurt like hell! I really feel for him that looks sooo sore and he was being so tough if it were me I think I would be complaining to high heaven! I loved the video though so satisfying to watch! X Claire X
Thanks for the great videos. Thanks for your reference in the video description showing no need for antibiotic in paronychia. However, I noticed that study was small but also specific to uncomplicated paronychia and felons. The situation in the video seems less simple due to the elevated nail bed, particularly smelly pus. I wonder if there was additional bacterial exposure that was not discussed. Thanks again for the video, I hope the patient recovered quickly and fully.
Smell and swelling would not be considered complications. Situations requiring reconsideration of antibiotics would be immune compromised status of the patient or something like a progression to sepsis.
It's wonderful to see a doctor who is conservative with antibiotic usage and doesn't treat them like lollies (candy to those in the US). I only mean, you're aware of up to date studies showing when and when not to use them. I get so frustrated when I see a very popular female RUclips doctor prescribing them and saying "only take them if you need to" after simple cyst removals. How is a lay person supposed to know if they're needed or not? (Rhetorical question). Antibiotics are such a precious resource, we need to be conservative with their usage, not give them to people who will likely take them just because they have them. Sorry I'll get off my soap box now lol. Cheers Ros from Aus.
Good video! I wouldn't mind an even closer view...😉😉 Thank you for sharing your work day and your nice patients! I personally look to RUclips when researching different medical issues. Im a person who believes one needs to be their own best health advocate.
I agree with the other comments - that poor mans' thumb looked so painful. When I was a 2nd year student nurse I saw my first ever operation, on a pilonidal sinus. This young man had recently returned home to Melbourne after a long road trip up the East coast of Australia, and he had a painful area at the base of his spine. Because he'd been driving around some very hot and dusty places, and he had a lot of body hair - basically a lump of hair had worked it's way under his skin and the area had become inflamed. It was weird though - on the surface of his skin you couldn't see anything unless you looked really closely and then you could see 3 tiny holes which oozed pus when I pressed (very gently of course!) around them. But when the surgeon opened up the area, he removed a huge lump of hair held together with pus. The 3 holes which were the pilonidal sinuses were made by the body to try to rid itself of the hair and pus. The human body really is incredible. Thank you Dr Vaughan for another great video. :-) PS. Did I spell pilonidal correctly? I'm not sure I did.
Pus is good. Pus drainage is even better! I know that felt so good to relieve that pressure. Is he more at risk for a fungal infection of that nail now?
great video..I see you chose to use aquaphor ointment on the wound. Do you not use triple antibiotic ointment or polysporin ointment because of the possibility of the bacitracin to cause local irritation?
Interesting video indeed...that was a pretty invasive case of paronychia that looks like it ended up being a successful procedure considering how bad it looked initially. Hopefully the post-op pain wasn't too bad from something that bad. I have to wonder if something mild like tramadol would be indicated in a case like this or if just a strong NSAID like ibuprofen 800mg would be sufficient for controlling pain for the few days following the visit...no matter the case though I was quite intrigued by the whole video and appreciate the depth of detail very much as well as the follow-up. Thanks again Dr. V!
That's even better news then...I'm glad just releasing all of that pressure and pus from his fingertip is able to lower the pain and soreness that much so quickly. I would have thought the drainage opening would be quite tender and painful, but since that's not the case then that's the best outcome that you could ever hope for in that kind of a situation!
+Or Bruck A journal article was referenced which described a study finding that antibiotics do not improve outcomes in paronychia drainage. Acute felon and paronychia: Antibiotics not necessary after surgical treatment. Prospective study of 46 patients. Pierrart J, Delgrande D, Mamane W, Tordjman D, Masmejean EH - Hand Surg Rehabil - February 1, 2016; 35 (1); 40-3
bagpussarah, We need help from our viewers to provide translations of captions. Many viewers can contribute portions of videos when they have time. The link to help: ruclips.net/user/timedtext_cs_panel?tab=2&c=UCOShHskqTZNneTshYWV14wQ
hi Dr . mark my finger is healing up nicley with no pain at all my swelling is pretty much gone and I had a follow up appt witbmy Dr Dan this morning and its all good still some minor drainage
Hydrogen peroxide is toxic to cells without a protective keratin barrier so it is not usually used now in open wounds. The irrigation action of the bubbles is the only benefit if provides, so it is not found to provide better results than irrigation with water or normal saline. Water or normal saline could be used in this wound, but it is not necessary as the infection cleared without using it.
Auburn Medical Group can't see, can't pee, can't spit, can't, uh, poop. The effects of anticholinergic drugs! Dry eyes, decreased urine output, dry mouth, and constipation. And I believe tachycardia which is not worked into the rhyme. This is one of the few rhymes I remember from pharmacology class. :)
They hit the radial nerve. I’ve actually had shots in it, then had surgery, like the carpal tunnel. Deadens the whole thumb. Some put a tourniquet on it.
hi dr mark I just had this done today at my Dr's office today on my index finger and I was numbed up and cut and green nasty infection and drained up to and no antiobtico was used either
The side of the thumb looked to contain more infection immediately following the procedure and at follow-up...was that also drained or allowed to heal on its own?
+Cody Powell I agree. On the video it looks like there is pus past the furthest extent of the incision at follow up. It was due to the texture of the skin combined with improperly corrected color on the video. It looked better in person.
I had a very bad ingrown toenail on my right big toe. it hurt so bad and was so infected. I honestly didn't care about the injections...as long as it got my toe fixed. but here's the funny thing about how the doctor did things...instead of certain places to numb me up, he poked me all over the two. no joke. I had counted 30 pricks. but I was numb lol. just was bad when the procedure was done because as I got up to stand my leg was numb! 😔but thinking about it, he did tell me that I was the 4 th person he has done that too.
Ouch! I cringed when you went under his nail. Glad he's feeling better too. Thanks for the great video Dr Vaughan!
It never ceases to amaze me how the body functions so efficiently. From everyday living, to trauma, then the process of healing!!!!! Wow! All of our trillions of cells that are parts of systems, working harmoniously almost always.............that's an understatement. lol Thanks Doc for allowing us to look in!
We love doing it.
This is the bravest man ive ever seen. So sorry for you having to go through this.
Wow that poor man. He is incredibly brave. That looks so painful!
+Happy Hippie it is an unpleasant procedure to experience.
did you ever find out what it was. I would love to know what happened with this patient
What a stoic patient. I'd be whining during those shots.
That had to hurt. Good job, Dr Vaughan.
What a brave man. I hope the problem
has been solved.
Great work Sir. I had to do this on myself! I used an elastic band to make it go numb and then use my leatherman multitool to drain and remove thorn. Lots of iodine was my saving grace and dressing changed every day. Bit of thorn was 3/4" long! ,very nasty. Healed perfectly thank God!
Wow, you were very brave
Boy that's a huge thumb!! Poor guy that must have hurt like hell! I really feel for him that looks sooo sore and he was being so tough if it were me I think I would be complaining to high heaven! I loved the video though so satisfying to watch! X Claire X
Thanks for adding the follow up visit. Your explanation of what was happening was great. Awesome job!
Thank you for including his followup. We didn't have to wonder how It turned out for him ~
✌🌷
You are so caring and awesome at explaining what you are doing.
Cynthia Brown Well said
Thank you for fixing the audio.
Thank you for noticing.
Much better with the sound! THANK YOU FOR FIXING IT! !
Thanks for the great videos. Thanks for your reference in the video description showing no need for antibiotic in paronychia. However, I noticed that study was small but also specific to uncomplicated paronychia and felons. The situation in the video seems less simple due to the elevated nail bed, particularly smelly pus. I wonder if there was additional bacterial exposure that was not discussed. Thanks again for the video, I hope the patient recovered quickly and fully.
Smell and swelling would not be considered complications. Situations requiring reconsideration of antibiotics would be immune compromised status of the patient or something like a progression to sepsis.
It's wonderful to see a doctor who is conservative with antibiotic usage and doesn't treat them like lollies (candy to those in the US). I only mean, you're aware of up to date studies showing when and when not to use them. I get so frustrated when I see a very popular female RUclips doctor prescribing them and saying "only take them if you need to" after simple cyst removals. How is a lay person supposed to know if they're needed or not? (Rhetorical question). Antibiotics are such a precious resource, we need to be conservative with their usage, not give them to people who will likely take them just because they have them. Sorry I'll get off my soap box now lol. Cheers Ros from Aus.
Hi great video that patient must have been in aggony but l was surprised you did not cut the nail right across.
I am scared, disgusted, intrigued, and satisfied. Poor guy. Glad you guys fixed it up for him.
Good video! I wouldn't mind an even closer view...😉😉 Thank you for sharing your work day and your nice patients! I personally look to RUclips when researching different medical issues. Im a person who believes one needs to be their own best health advocate.
Ouch!!! Bless his heart!!!
I agree with the other comments - that poor mans' thumb looked so painful. When I was a 2nd year student nurse I saw my first ever operation, on a pilonidal sinus. This young man had recently returned home to Melbourne after a long road trip up the East coast of Australia, and he had a painful area at the base of his spine. Because he'd been driving around some very hot and dusty places, and he had a lot of body hair - basically a lump of hair had worked it's way under his skin and the area had become inflamed. It was weird though - on the surface of his skin you couldn't see anything unless you looked really closely and then you could see 3 tiny holes which oozed pus when I pressed (very gently of course!) around them. But when the surgeon opened up the area, he removed a huge lump of hair held together with pus. The 3 holes which were the pilonidal sinuses were made by the body to try to rid itself of the hair and pus. The human body really is incredible. Thank you Dr Vaughan for another great video. :-) PS. Did I spell pilonidal correctly? I'm not sure I did.
There is three holes and just post coming now that sounds gross kind of
Well did you get your THUMBnail.
I'm sorry
Pus is good. Pus drainage is even better! I know that felt so good to relieve that pressure. Is he more at risk for a fungal infection of that nail now?
We bored a hole in ours when we hit it & blood formed under skin, it relieved pain & bleed out !!!
O.M.G.!! I had butterflies in my stomach watching that
Nicely done and good to see the follow up
Oh that was so painful. !!
Omg! I just discovered I no longer have a sensitive stomach🤦🏻♀️ I am eating cheese sticks & watching this video at the same time🤣
I love watching procedures but needle injections I have to look away or ff past it...
I would love to see more updates on this thumb!
Thanks for sharing! In my next life i will have a career in the medical field.
love these videos thanks
Good to hear
great video..I see you chose to use aquaphor ointment on the wound. Do you not use triple antibiotic ointment or polysporin ointment because of the possibility of the bacitracin to cause local irritation?
Yes
Interesting video indeed...that was a pretty invasive case of paronychia that looks like it ended up being a successful procedure considering how bad it looked initially. Hopefully the post-op pain wasn't too bad from something that bad. I have to wonder if something mild like tramadol would be indicated in a case like this or if just a strong NSAID like ibuprofen 800mg would be sufficient for controlling pain for the few days following the visit...no matter the case though I was quite intrigued by the whole video and appreciate the depth of detail very much as well as the follow-up. Thanks again Dr. V!
The pain is almost instantly relieved by releasing the pressure when it is drained. It is just sore after the procedure.
That's even better news then...I'm glad just releasing all of that pressure and pus from his fingertip is able to lower the pain and soreness that much so quickly. I would have thought the drainage opening would be quite tender and painful, but since that's not the case then that's the best outcome that you could ever hope for in that kind of a situation!
Question: if the thumb had been soaked in Epsom salts from the first and then the nail removed could the infection been prevented?
Can you please cite the study which showed that oral ABx are not necessary for paronychia. Thanks in advance.
+Or Bruck A journal article was referenced which described a study finding that antibiotics do not improve outcomes in paronychia drainage. Acute felon and paronychia: Antibiotics not necessary after surgical treatment. Prospective study of 46 patients.
Pierrart J, Delgrande D, Mamane W, Tordjman D, Masmejean EH - Hand Surg Rehabil - February 1, 2016; 35 (1); 40-3
That looked gnarly! Did you test it for mrsa?
Great videos and very informative but who does the subtitles ? There are so many errors.
bagpussarah, We need help from our viewers to provide translations of captions. Many viewers can contribute portions of videos when they have time. The link to help:
ruclips.net/user/timedtext_cs_panel?tab=2&c=UCOShHskqTZNneTshYWV14wQ
Doctor On a scale of 1 to 10, with 10 being the worst, how would you rate the odor? btw what is your name?
I fell down a RUclips hole again
hi Dr . mark my finger is healing up nicley with no pain at all my swelling is pretty much gone and I had a follow up appt witbmy Dr Dan this morning and its all good still some minor drainage
Good
Would flushing with hydrogen peroxide help clean out the infection?
Hydrogen peroxide is toxic to cells without a protective keratin barrier so it is not usually used now in open wounds. The irrigation action of the bubbles is the only benefit if provides, so it is not found to provide better results than irrigation with water or normal saline. Water or normal saline could be used in this wound, but it is not necessary as the infection cleared without using it.
Okay, thank you.
Ouch! Great video.... fingers, nose, penis, toes, it's sad but so funny, sorta has a rhyme jingle.
Medicine is full of rhymes.
Auburn Medical Group can't see, can't pee, can't spit, can't, uh, poop. The effects of anticholinergic drugs! Dry eyes, decreased urine output, dry mouth, and constipation. And I believe tachycardia which is not worked into the rhyme. This is one of the few rhymes I remember from pharmacology class. :)
They hit the radial nerve. I’ve actually had shots in it, then had surgery, like the carpal tunnel. Deadens the whole thumb. Some put a tourniquet on it.
Is the presence of a stronger odor an indication of a slightly more serious infection?
It just confirms the presence of bacterial activity. There are some bacteria that have particularly unique smells, like Pseudomonas aeruginosa.
is there a follow up picture of his thumb now?
hi dr mark I just had this done today at my Dr's office today on my index finger and I was numbed up and cut and green nasty infection and drained up to and no antiobtico was used either
+Kim Mnikolaicik I hope you have a speedy recovery with no pain.
The side of the thumb looked to contain more infection immediately following the procedure and at follow-up...was that also drained or allowed to heal on its own?
+Cody Powell I agree. On the video it looks like there is pus past the furthest extent of the incision at follow up. It was due to the texture of the skin combined with improperly corrected color on the video. It looked better in person.
Thanks for the answer! Love the channel
Please share it.
Auburn Washington??
California
Does anyone Read all the errors in the subtitles?
on the bottom left near the cuticle, why wasn't that cleared of the yellow or pocket of what looked like pus?
It only looks like pus on the video. I also noticed that while editing the video.
Wow that makes my thumb hurt like hell. Hope he is doing well
😣😣😣😣😣😣
Hi from Virginia
Omg It looks really really painful
way to make him feel bad about his smelly finger lololol
+Chilltownify it was unique in its strength, but the smell was typical.
DEAR GOD
I'd've passed out. I nearly fainted when I had my carpal tunnel decompression done, and I was laying down 😝
I had a very bad ingrown toenail on my right big toe. it hurt so bad and was so infected. I honestly didn't care about the injections...as long as it got my toe fixed. but here's the funny thing about how the doctor did things...instead of certain places to numb me up, he poked me all over the two. no joke. I had counted 30 pricks. but I was numb lol. just was bad when the procedure was done because as I got up to stand my leg was numb! 😔but thinking about it, he did tell me that I was the 4 th person he has done that too.
what would you describe the smell as?
I was so happy to see this.
It is not unlike other bacterial smells of the human body which can be sampled at either end of the alimentary (digestive) canal.
Auburn Medical Group Understood!!! 😄
Auburn Medical Group that was the most diplomatic answer I've ever read. 😆
Under nail not skin !
My bff had one on his toe and they had to remove the nail
Can you see a splinter on X-ray
cultures?
Ouch!
Ouch.
I just watched a video of a man getting decapitated with ease but every time he sticks that needle in I cant look
Ouch!,,,,,,,
Ethyl chloride?
Yes
They looks like a spider or snake bite, but Ik it's not
+ZindoGamer I think it was a wooden splinter.
Auburn Medical Group wow
oh yea this is what came for....whoooo!
+Regina Sclafford it was a good one.
Auburn Medical Group why do pimples make a tiny pop sound when popped?
I guess it is because they are tiny.
👍
ouch!!
なんで日本語なんや、、、
You should be able to get Japanese captions if you turn your captions on in the RUclips player.