There is evidence that with increased housing construction and remodeling going on after the recession during the mid-2000s, nail gun injuries to the hand have also gone up. It is estimated that half of all nail gun injuries affect the hands and fingers. Up to 14 per cent of those accidents occur during carpentry projects at home (compared with just less than four per cent among worker compensation claims). So safety at home is an important issue.
Once the individual has driven a nail with a nail gun into the hand, careful evaluation by the hand surgeon is required. Treatment can range from simple wound care to major microvascular surgery. The decision on how to manage the case depends on multiple factors. One important aspect of treatment is to avoid further tissue damage.
The following are some tips and guidelines presented by hand surgeons from the Mayo Clinic in Rochester, Minnesota when dealing with nail gun injuries to the hand:
The wound must be cleaned within the zone of injury and damage repaired. Sometimes this can be done in one procedure. But when there is extensive contamination, a series of surgeries is required. In all cases, infection (and preventing infection) is a number one concern.
The authors provide surgeons with specific information on techniques for nail extraction. Patient photos at the time of admission and interoperative photos are provided with a description of how-to remove the nail and any item it may still be attached to (often a piece of board). When to perform exploratory surgery and when to extract the nail during a surgical procedure are discussed in detail. How to handle contaminated nails that have entered the bone is an additional feature of this article.
The authors end by reminding surgeons of the need for patient safety education. It may seem like common sense that a first injury would be a wake-up call to use protective gear but many patients have more than one episode of nail gun injuries to the hand. Gloves, goggles, and helmets are advised. The National Institute for Occupational Safety and Health (NIOSH) has a nail gun safety guide for construction contractors that can be just as informative for the do-it-yourself home owner.