The Most Annoying Pain in the Office

By CodingStrategies on October 13th, 2017

They always strike when least expected – opening the mail, rummaging through papers on a desk, filing forms – and in an instant there is excruciating agony from a dreaded paper cut. Since the dawn of office work, it has been the one thing that can make the most professional businessperson swear a blue streak. A paper cut occurs when a piece of paper or other thin, sharp material slices into a person’s skin. Though commonly caused by paper, these cuts can also be caused by aluminum foil, thin plastic and packing materials, such as boxes or cardboard. 

A paper cut is typically very small, but surprisingly painful. While these can occur on any part of the body, they occur most often on the fingertips. Fingertips and hands have significantly more nerve fibers per square millimeter than most of the rest of the body. In addition, the suffering is prolonged because paper cuts bleed very little, leaving the pain receptors open to the air.

A paper cut (ICD-10-CM code W26.2XXA, Contact with the edge of stiff paper, initial encounter) is similar to a slash with a razor blade, with one essential difference. A razor blade makes a smooth, clean incision in the skin, leaving behind little if any foreign material that could cause the wound to be infected. In the same manner, a paper cut rips through the skin, but also deposits particles that really sting and causes more microscopic damage to the tissues. Think of a paper cut like a dull knife used to cut a steak; although you can’t see the full result of a paper cut with a naked eye, mutilation of the tissue has occurred. 

A frequent claim is that paper is porous, and therefore, a better host to bacteria than the clean surface of a razor or knife. As a result, caring for a paper cut means keeping it clean and protected. It is prudent to wash the affected area thoroughly (and while ignoring the pain) and cover it with a bandage and antibacterial ointment.Remember, bacteria doesn’t cause pain – pain comes with an infection, resulting in inflamed skin that is trying to fight off the bacteria.

Painful, but not that bad, right? For most folks, anyway. However,in September 2016 Michael Berger of New Jersey almost died from a paper cut. More specifically, a paper cut on his right index finger turned into sepsis (Codes R65.20, Severe sepsis without septic shock; and S61.210A, Laceration without foreign body of right index finger without damage to nail, initial encounter), and a three week medically induced coma. Sepsis is a toxic response to an infection that can lead to rapid organ failure, and if not arrested, to death. In addition, the diagnosis of sepsis may be missed because there is no specific test for this condition and patient symptoms can vary. Michael was given a 50 percent chance of survival when he arrived at the emergency room, but the combination of IV fluids, antibiotics and careful monitoring pulled him through. Where Michael contracted the sepsis is still a mystery, but Michael is completely recovered and will remain vigilant against future infections.

A million Americans are diagnosed with sepsis every year and it has been declared a medical emergency by the Centers for Disease Control and Prevention. Sepsis kills 258,000 people annually, more deaths than breast cancer, prostate cancer and AIDs combined.

There is an inherent risk in handling paper, and some papers are so thin that their edges are like razors. To play it safe, read the newspaper; it is printed on thin paper made from a combination of recycled matter and wood pulp, and not intended to last very long. Because of the manufacturing process, newspaper is least likely to cause a papercut. Of course to be doubly certain to avoid a paper cut, read the news online!