FROM EMERGENCY MEDICINE JOURNAL
Clinicians can use a pair of large surgical bolt cutters to safely and quickly cut a titanium ring from a patient’s swollen finger, and then can pull apart the edges with two paper clips, according to a letter published online in Emergency Medicine Journal.
“Our method used simple equipment that is readily available in most hospitals at all times, took less than 30 seconds to perform, and could be performed by a sole operator without damage to the underlying finger,” wrote Dr. Andrej Salibi and Dr. Andrew Morritt at Sheffield (England) Teaching Hospital NHS Foundation (2015 Aug 13; doi: 10.1136/emermed-2015-204962).
Ring constriction is a fairly common problem that can cause necrosis and loss of the digit if the ring is not removed. Basic ring cutters can sever gold and silver, but not titanium, which has become popular for rings because it is hypoallergenic, durable, lightweight, and strong – so strong that diamond-tipped saws or drills can take up to 15 minutes to cut these rings, the surgeons noted. Many facilities also lack access to such equipment, and it generates enough heat that an assistant must irrigate the surrounding skin to prevent burns, they said.
Their case report described a patient who bathed in warm water at a spa and developed a painful, swollen finger that was constricted by a titanium wedding band. Elevation and lubrication at the emergency department failed to remove the ring, as did finger binding and use of a manual ring cutter.
“The fire service was called and attempted removal using specialized cutting equipment, which also failed,” the surgeons wrote. “The patient was then admitted under the plastic surgery service for hand elevation, and further attempts 8 hours later blunted two manual ring cutters.” At this point, they borrowed a large pair of bolt cutters from the operating room, which quickly severed the ring without harming the finger. Then they applied lateral traction with a pair of paper clips and removed it, they said.
The authors declared no funding sources or conflicts of interest.