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Carving pumpkins is a fall tradition in many families, but as Halloween approaches, Dr. Ari Mayerfield, Hand Surgeon at the New York Group for Plastic Surgery, warns parents and children to use caution and the appropriate tools when carving pumpkins to avoid potentially serious hand injuries.

Every year, surgeons and hand therapists treat patients with injuries related to pumpkin carving. According to the American Academy of Orthopaedic Surgeons (AAOS), pumpkin-carving can result in lacerations to the hand and also injuries to bones and tendons.

"Hand injuries at this time of year occur frequently when children and adults try to use kitchen knives to carve pumpkins," says Dr. Mayerfield who practices at NewYork-Presbyterian/Hudson Valley Hospital. "Pumpkins have a very tough outer skin and usually require a sharp blade to cut through. Most knives used, including kitchen knives, lack a safety guard to protect the hand from slipping down the blade, increasing the risk of serious injury."

Hand injuries from pumpkin carving can be so severe that nerve or tendon damage may result, affecting the function of the hand. Parents can prevent painful or serious hand injuries by providing alternative decorating activities allowing children to be a part of creating a Halloween pumpkin. "Accidents that happen in just a second, can result in devastating injuries that may require surgery and several months of rehabilitation," says Erin Leary, Lead Occupational Therapist and Certified Hand Therapist at NewYork-Presbyterian/Hudson Valley Hospital.

Dr. Mayerfield recommends decorating a pumpkin with paints, stickers, or markers, or dressing the pumpkin in costumes as a way for small children to safely participate in Halloween activities. For older children and adults, a pumpkin carving knife should be used. Pumpkin carving kits are commercially available and feature tools that are specially designed for use in the creation of Jack-O-Lanterns. A sawing motion, rather than a sharp cutting action, should be used to help prevent serious hand injuries.

When carving pumpkins, keep the following safety tips in mind:

• Never leave children unattended with carving tools.
• Let adults do the carving. Children can draw designs on the pumpkin or help remove the pulp
• Carve in a clean, well-lit, dry area. Any moisture on your tools, hands or table can cause slipping that can lead to injuries.
• Carve in a clean, well-lit, dry area. Any moisture on your tools, hands or table can cause slipping that can lead to injuries.
• Sharper knives are not necessarily better for carving. Pumpkin carving saws are the safest tools for carving.
• When carving, cut away from your body in small and controlled strokes.
• Cuts and injuries can occur even when you put safety first. Apply pressure to minor cuts using a clean cloth to stop bleeding. If bleeding, stiffness or numbness persists for more than 15 minutes, or if the injury is visibly serious, seek medical attention immediately from a hospital emergency department.

If an injury does occur, Dr. Mayerfield recommends the following steps be taken:

• Elevate the hand above the heart and apply pressure to the wound with a clean cloth.
• If after applying continuous pressure for 15 minutes does not stop the bleeding, seek emergency care
• If any numbness or inability to move the fingers occurs, seek emergency care.

"Immediate medical attention is important," said Dr. Mayerfield. "The longer a patient waits to seek medical attention, the more difficult the repair will be."

Dr Mayerfield is a Hand and Upper Extremity Surgeon at The New York Group for Plastic Surgery at NewYork-Presbyterian/Hudson Valley Hospital.

Erin Leary, OTR/L, CHT, is a Certified Hand Therapist at NewYork-Presbyterian/Hudson Valley Hospital.