Stop your green fingers seeing red

Gardening is a delight, but be mindful of the secateurs when pruning your Euphorbia

The season of mists and mellow fruitfulness is fast approaching, and there’s plenty of useful gardening to do. Pottering about is satisfying, the fading light enhancing a sense of intimacy with the earth while autumnal plots are tended: sewing grass seeds on those bare patches in the lawn; trimming the lavender; deadheading; planting spring bulbs – just some of the tasks that form part of the autumn gardening calendar.

A 2013 survey of 1,500 British adults, carried out on behalf of Gardeners' World magazine, found that 80 per cent of gardeners feel satisfied with their lives, compared with 67 per cent of non-gardeners. The survey also revealed that 93 per cent of gardeners think that gardening improves their mood . . . despite, presumably, their sore knees, muck-filled finger nails and aching backs.

It's hard to explain the sense of enjoyment that a spell in the garden brings, but this is excused by John Carey, who observed: "[gardening] lies beyond the reach of words, and you wouldn't need it if it didn't."  Yes, gardening is typically a wordless pursuit, but sometimes words erupt – perhaps expletives – if, say, while shuffling about in the gathering gloom I stand on a rake; trip over the hose; or prune a finger when it should have been a rose stem.

The first rose-related injury to achieve widespread recognition was probably that sustained in Oxford by reserve policeman Albert Alexander, who – so the story goes – was scratched near his mouth by a thorn. Infection ensued, and although, on February 12th, 1941, he became the first person to receive effective penicillin treatment, there were insufficient supplies to sustain his recovery, and he died.


The wounds usually become infected, prompting surgical washout

Mr Cormac Joyce, specialist registrar in plastic surgery at the Mater Hospital, Dublin, told The Irish Times that blackthorn injuries are also encountered relatively often: "The blackthorn," he said, "is a plant well known for causing infections, and inflammatory reactions in soft tissue structures. The blackthorn," he said, "is a plant well known for causing infections, and tissue reactions in joints.  The initial thorn injury is usually a small and innocuous puncture wound to a finger and medical attention is seldom sought.  However, the wounds usually become infected, prompting surgical washout and removal of the foreign body."

One foreign body that proved particularly troublesome was reported this year in the journal Internal Emergency Medicine, describing a 30-year-old male who turned up at A&E nursing a painful, swollen forearm. He recalled that a fortnight before, while working in his garden, he had jabbed himself while working close to a cactus. Although an X-ray revealed nothing of interest, ultrasound detected a 2cm cactus spine lodged deep in the muscles of his forearm. The spine was removed and, unlike Albert Alexander 76 years before, he was successfully treated with antibiotics.

Perhaps you haven't yet got round to pruning those fruit trees that should have been done at the end of the summer, so take care while wielding the secateurs. And there are other aspects of pruning to be wary of, apart from the risk of inadvertent snipping of fingers and thumbs. For example, in a piece for the Emergency Medical Journal entitled "Beware the ornamental plant", Dr Amissah-Arthur and colleagues describe how an 86-year-old female presented at A&E "with a burning, painful, watery [right] eye" and was diagnosed with a corneal abrasion for which she was treated with chloramphenicol ointment. Two days later she had conjunctivitis in her left eye. It transpired that she had been pruning her Euphorbia lacteo patio plant when some sap had got onto her fingers, which she inadvertently transferred to her eye. She was successfully treated, and the authors note that Euphorbia sap has been documented to be toxic to both eyes and skin.

As for penetrating eye injuries, it's interesting to note that when researchers considered the topic for the Journal of Public Health, they found that among a population of patients who underwent surgery for eye trauma, "[a]ccidents from DIY or gardening were the cause in 17 of 33 (51.5 per cent) patients, with a failure to wear eye protection in all cases". The authors also found that both DIY stores and garden centres were rather poor in their efforts to promote eye safety in their shops and on their websites.

The most common gardening injuries we see in plastic surgery are attributable to lawnmowers

But away from the herbaceous borders and prickly foliage, once you’ve stepped onto the wide-open, wind-swept plains of the lawn to give the grass its last cut before winter, that’s when the racket of fired-up cutting machines freights the cool autumnal air with hazard: “By far,” says Cormac Joyce, “the most common gardening injuries we see in plastic surgery are attributable to lawnmowers during the summer months.  The exact mechanism of injury described by patients is invariably the same: they turn off the lawnmower and pick it up to put it away.  However, the blades are still turning and they inadvertently put their hand into the spinning blades resulting in multiple fingertip injuries. We usually see a couple of these injuries every week.”

Mr Joyce has also observed a growing number of traumas related to ride-on lawnmowers: “Thankfully they are not as common, but the injuries sustained tend to be far more serious.” This is borne out by the results of a 10-year study of lawnmower injuries in children which found that ride-on lawnmower injuries had a higher injury severity score and length of hospital stay – 15 days versus two days – compared with standard lawnmowers.

In a review of lawnmower injuries published in the Journal of Emergency Nursing, Nurse Jean Mullins cited evidence that "injuries from projectiles, typically rocks, wires, or glass, account for 17 per cent of all lawn mower injuries". She also points out that rotary mower blades can achieve speeds of 3,000rpm, which means that "a 1.5lb object could be launched at 232 miles per hour".

After lawnmowers, Joyce explains, upper limb injuries from hedge trimmers and chainsaws are the next most common gardening injury: “These can range from simple lacerations to more traumatic amputations.”

Gardening, like listening to music, is typically a wordless pursuit, allowing one to disengage temporarily from the world, but please ensure that you don’t disengage completely this autumn: your safety is at stake.