Clinical characteristics and management of wound foreign bodies in the ED

Levine, Matthew R.; Gorman, Stephen M.; Young, Christian F.; Courtney, D. Mark

doi:10.1016/j.ajem.2007.11.026

Cited by 69 publications

(56 citation statements)

References 12 publications

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“…were utilized, wood and glass FBs were missed in 93% and 25% of the cases, respectively, so ultrasound was suggested to be the more sensitive and preferred technique for imaging of wooden FBs. [11] We used no imaging in 25.6% of the cases in which significant parts of the FBs were visible externally. Whatever the chosen imaging technique, it is very important to keep still the injured extremity and the FB during the clinical evaluations and radiological investigations in order to prevent injury to surrounding structures.…”

Section: Resultsmentioning

confidence: 99%

Foreign Body Penetrations of Hand and Wrist; a Retrospective Study

Hocaoğlu

Kuvat²,

Özalp³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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Section: Resultsmentioning

confidence: 99%

Foreign Body Penetrations of Hand and Wrist; a Retrospective Study

Hocaoğlu

Kuvat²,

Özalp³

et al. 2013

Ulus Travma Acil Cerrahi Derg

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“…Our observation contrasts to that of Levine et al who reported majority of their patients presenting within 48 hours. 10 Salati et al reported that only 10% of his cases attended within 2 weeks of injury, rest of 90% came after two weeks. 8 Our findings are comparable to that of Salati as two third of our patients presented after two weeks of initial injury.…”

Section: Discussionmentioning

confidence: 99%

Presentation and Management of Soft-Tissue Foreign Bodies in a Teaching Hospital of Western Nepal

Joshi¹,

Dwivedi²

2016

J Lumbini Med Coll

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Introduction: Accidental penetrating injuries with foreign bodies are a common presentation in hospital's emergency rooms. If missed, these bodies can remain dormant or result in a wide range of complications. This study evaluated the characteristics of patients, presentation and management who suffered foreign body embedded in soft tissue at a teaching hospital of Western Nepal. Methods: The study was conducted at Department of Orthopaedics, Lumbini Medical College Teaching Hospital from September 2013 to August 2015. All cases confirmed to have a foreign body in soft tissue were enrolled. Surgical exploration with removal of foreign body was carried in operating room under tourniquet control. The patient demographics, cause of injury, nature of foreign body, occupation of the patient, diagnostic yield of radioimaging, procedures undertaken for retrieval of foreign body, and complications were recorded. All patients were followed-up up to five months. Results: Total 28 patients, nine (32.1%) males and 19 females (67.9%) were observed. The mean age was 35.6 yr (SD=11.1). Housewives (n=14, 50%) were the common sufferers. Most of our patients (n=17, 60.7%) presented two weeks after injury. Accidental prick while cutting grass or tree was the common mode (n=13, 46.3%) of injury and among foreign bodies, wooden or vegetative were the commonest (n=19, 67.9%) observed. Among the extremities, hand (n=10, 35.7%) and foot (n=5, 17.9%) were commonly affected. All patients had successful surgical exploration and retrieval of the foreign bodies under anesthesia and tourniquet control in operating room. Image intensifier was employed in seven cases to locate the foreign bodies per-operatively. Wound infection developed in 14.2% (n=4) of patients, all of whom were managed successfully with oral antibiotics. None of the patients required re-hospitalization. All patients were fine at final five months follow up. Conclusion: Managing foreign body embedded in the soft tissue are challenging. Surgical exploration under tourniquet control suffice a definitive management. At times, image intensifier is required to locate the foreign body.

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“…This pitfall was highlighted by Levine and his colleagues in a retrospective review of 490 cases of foreign bodies in the limbs. They reported that radiographs were ordered in only 50% of the time and radiograph had a sensitivity of nearly 100% for detecting metal but missed 95% of wood 25% of glass foreign bodies (2) . Although not all of glass foreign bodies are radiolucent, the back coating of the multiple pieces of mirror fragments apparently enhanced the visibility of the foreign bodies on plain radiograph in this patient.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, these FBs may not be discovered until much later. Studies have indicated that up to 25%-38% of patients with retained foreign bodies present weeks, months or even years after the initial injury (1,2) . Monu et al reported I n a series of cases of patients whose foreign bodies became symptomatic after 10years of the initial injury and in whom neoplastic lesions were suspected until exploration revealed the foreign bodies (3) .…”

Section: Discussionmentioning

confidence: 99%

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Missed Embedded Large Glass Foreign Bodies in the Body

Ibeanusi

Harcourt²

2017

IAM

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Background: Impaled foreign body in traumatic wounds is often a common finding in the Accident and Emergency room of hospitals especially when the mechanism of injury is penetrating. These Foreign bodies can be missed if they are embedded and radiolucent. A high index of suspicion, thorough examination, and appropriate investigations is required for appropriate diagnosis and treatment. Setting: University of Port Harcourt Teaching Hospital Port Harcourt. Case Report: This is a case of a 28-year old soldier who presented with symptoms from missed embedded multiple glass foreign body following injury from a road traffic crash four months earlier. He had further clinical assessment and successful wound exploration to remove the missed foreign body. Conclusion: Missed foreign body in traumatic wounds is possible especially if embedded. A high index of suspicion, thorough clinical assessment and appropriate investigations, are required to identify such objects to enable appropriate and complete treatment.

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Clinical characteristics and management of wound foreign bodies in the ED

Cited by 69 publications

References 12 publications

Foreign Body Penetrations of Hand and Wrist; a Retrospective Study

Foreign Body Penetrations of Hand and Wrist; a Retrospective Study

Presentation and Management of Soft-Tissue Foreign Bodies in a Teaching Hospital of Western Nepal

Missed Embedded Large Glass Foreign Bodies in the Body

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