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{
    "pk": 15489,
    "title": "Up in Flames: The Safety of Electrocautery Trephination of Subungual Hematomas with Acrylic Nails",
    "subtitle": null,
    "abstract": "Introduction:\n Subungual hematomas are fingertip injuries, generally secondary to blunt trauma, that  cause pain due to an accumulation of blood under the fingernail. It is generally considered standard  of practice to relieve this accumulation by means of trephination with a hollow tip needle, a heated  paper clip, or electrocautery. It has been assumed that due to the flammable properties of acrylic,  trephination via electrocautery has the potential to ignite acrylic nails and cause burns and other  potentially serious injury, making electrocautery contraindicated in patients with acrylic nails. Our  thorough literature review failed to support or refute this assumption; so in the interest of ensuring  that this practice is evidence-based, we sought to explore this topic.\nMethods:\n In this study we used electrocautery trephination on acrylic nail products attached to  simulated digits and recorded the presence and frequency of ignition events. We hypothesized  that ignition would occur with sufficient frequency to support continuing the practice of avoiding  electrocautery trephination in subungual hematomas with overlying acrylic nails.\nResults:\n In our study, we exposed 200 acrylic nails to trephination with electrocautery, and 83 nails  ignited (41.5%).\nConclusion:\n While other variables exist, these findings do support the current practice pattern of  avoiding trephination with electrocautery in those patients with acrylic nails overlying subungual  hematomas.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "subungual hematoma"
        },
        {
            "word": "electrocautery trephination"
        },
        {
            "word": "trephination, acrylic nails"
        }
    ],
    "section": "Injury Prevention and Population Health",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/2771w4mr",
    "frozenauthors": [
        {
            "first_name": "Claude",
            "middle_name": "",
            "last_name": "Blereau",
            "name_suffix": "",
            "institution": "Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington",
            "department": "None"
        },
        {
            "first_name": "Steven",
            "middle_name": "",
            "last_name": "Radloff",
            "name_suffix": "",
            "institution": "Madigan Army Medical Center, Department of Emergency Medicine, Joint Base Lewis-McChord, Washington",
            "department": "None"
        },
        {
            "first_name": "Justin",
            "middle_name": "",
            "last_name": "Grisham",
            "name_suffix": "",
            "institution": "Evans Army Community Hospital, Department of Emergency Medicine, Fort Carson, Colorado",
            "department": "None"
        }
    ],
    "date_submitted": "2021-06-08T23:10:47+01:00",
    "date_accepted": "2021-06-08T23:10:47+01:00",
    "date_published": "2022-02-24T05:49:11Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/15489/galley/7800/download/"
        }
    ]
}