Melbourne Hand Surgery 

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Latest news: We request that you wear a mask when you attend our practice in person, and that you log your attendance via our Victorian Government QR code, by entering location code 3D7RE3 into the Services Victoria App or by writing your details on the physical register at our reception. Elective hospital surgeries are now unrestricted and you no longer need to have a COVID test prior to hospital admission. Dr Tomlinson is operating at The Avenue and Glenferrie Private; Epworth Cliveden is indefinitely closed at this time. 

All suitable consultations at Melbourne Hand Surgery are currently conducted via telehealth at our dedicated virtual clinic to maximise patient and staff safety. We have implemented enhanced hygiene measures in our rooms including acrylic screens, masks, hand sanitiser, face shields and physical distancing-related changes. We require that all patients provide a referral prior to booking an appointment so that we can identify and manage urgent and emergency conditions in a timely manner, and so that our surgeons can assess your suitability for a telehealth appointment and identify any further information or tests that might be required before your consultation.

Animal bites

hand feeding ducksWhether it's a cat bite, dog bite, bird bite or human bite, if you have a bite injury you should seek urgent medical attention. Even if the wound seems minor it is possible that you may develop a severe infection that requires hospitalisation, multiple surgeries and lengthy courses of antibiotics. This is especially so for patients who smoke, or have diabetes or other medical conditions that make them susceptible to hand infections. 

If the wound extends through the skin it is recommended that this be explored and thoroughly washed out by a qualified specialist, either in an emergency department or an operating theatre. Broad spectrum antibiotics are recommended, along with a tetanus booster if you are due for this. Splinting and elevation are additional therapies that will reduce the risk of infection.

Signs to watch out for

If you have received a bite injury and you have ongoing or worsening throbbing and pain from the site despite initial treatment this is a sign of infection until proven otherwise. It is imperative that you return to a hospital emergency department or surgical specialist for further assessment and treatment.

Other signs of infection include

  • redness at the site of the wound
  • redness spreading up the hand or forearm
  • pus coming from the wound
  • swelling
  • worsening pain on movement
  • fever
  • shakes and chills
  • feeling generally unwell

Signs that you may have received an injury to structures below the skin include

  • numbness or shooting 'electrical' pain with movement 
  • reduced range of movement or absent movement of a joint
  • deep pain on movement
  • spurting blood from the wound

If you have any of these symptoms please seek urgent medical treatment.

Suggested antibiotics

Antibiotic therapy is prescribed in addition to proper washout of your wound. Antibiotic therapy alone is insufficient to overcome a "dirty" wound. Your surgeon will take your allergies and the type of bite into consideration when prescribing an antibiotic; in cases of severe infection advice from an infectious diseases specialist may be sought. If you have a true allergy to penicillin you will not be prescribed an antibiotic that contains amoxycillin.

capsules 200x150Parakeets - ciprofloxacin or trimethoprim/sulphamethoxazole
Cockatoos - clindamycin
Parrots - amoxycillin/ clavulanic acid
Cats - amoxycillin/ clavulanic acid
Dogs - amoxycillin/ clavulanic acid
Humans - amoxycillin/clavulanic acid
Fish - ciprofloxacin

References

Meyer CL, Abzug JM, Domestic Bird Bites. J Hand Surg (Am) 2012 Apr 24 ePub ahead of print.

FRACS

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