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Subject: Ring Removal
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Manual ring cutter
Umbilical tape (2 to 4 mm wide) or 0-gauge or larger braided suture
Powder-free, latex surgical glove
Motorized handheld grinder (such as a Dremel tool)
Removal of a ring or other constricting object from a swollen digit or one that could potentially become compromised
In the presence of lacerations or neurovascular compromise, the ring-cutting technique should be employed rather than the more time-consuming ring-sparing options.
PITFALL: Avoid the use of material that is too thin, such as monofilament or thin sutures, because of potential skin damage and decreased effectiveness.
PITFALL: Use latex-free material in anyone with a possible latex allergy because latex could worsen the swelling.
PITFALL: Avoid excessive trauma and pressure to the digit. Even with mild pressure, the patient must be warned that some discomfort may be experienced.
Pearl: If the object is too thick or tempered for removal by this method (e.g., steel nuts), consider the use of a motorized, handheld circular cutter/grinder (such as a Dremel tool). A silicone rubber band or other similar material should be placed between the skin and the cutting site to protect the underlying tissue.
Pearl: Two cuts 180 degrees apart are usually necessary for large or hardened objects.
Injury to the underlying skin, lymphatics, and neurovascular bundle.
Fracture of the proximal phalanx or disruption of the finger joint mechanism.
The benefits, risks, and medical necessity of the ring removal should be considered prior to attempting the procedure.