Puncture Wounds of the Foot

Haverstock, Brent D.

doi:10.1016/j.cpm.2012.02.002

Cited by 12 publications

(16 citation statements)

References 11 publications

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“…These differences in wound bacteriology may be due to interspecies variation in the oral flora of the related snakes [ 10 ]. A higher infection rate was observed in our study compared to a previous study (11.4% vs 6%) [ 4 ], however we defined wound infection based on the criteria used by Mao et al [ 9 , 10 ], and it is noteworthy that 10% - 70% of inanimate object puncture wounds develop infectious complications [ 34 ]. Based on the bacteriology findings, we suggest a first-generation cephalosporine with aminoglycoside, or sulfamethoxazole/trimethoprim as initial antibiotics for the management of infected T .…”

Section: Discussionmentioning

confidence: 52%

Envenomation by Trimeresurus stejnegeri stejnegeri: clinical manifestations, treatment and associated factors for wound necrosis

Chiang

Tsai

Liu

et al. 2020

J. Venom. Anim. Toxins incl. Trop. Dis

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Background: Trimeresurus stejnegeri stejnegeri bite induces tissue swelling, pain, thrombocytopenia, rhabdomyolysis, and acute renal failure. However, the incidence of coagulopathy, factors associated with wound necrosis, and the appropriate management of this condition have not been well characterized yet. Materials: This study included patients bitten by T . s . stejnegeri that were admitted to the study hospitals from 2001 to 2016. Patient characteristics, laboratory data, and management approaches were compared in victims with and without wound necrosis. Results: A total of 185 patients were evaluated: three patients (1.6%) were asymptomatic; whereas tissue swelling and pain, local ecchymosis, wound necrosis, coagulopathy, thrombocytopenia, rhabdomyolysis, and renal impairment were present in 182, 53, 13, 15, 10, 1, and 3 patients, respectively. One patient died from coagulopathy and hemorrhagic shock. Antivenom was administered to all envenomed patients at a median time of 1.8 h after the bite. The median total dose of antivenom was five vials. Chi-square analysis showed that bitten fingers, using cold packs during first aid, presence of bullae or blisters, lymphangitis or lymphadenitis, local numbness and suspected infection to be significantly associated with wound necrosis. After adjustment using a multivariate logistic regression model, only cold packs as first aid, bulla or blister formation, and wound infection remained significant. Conclusions: The main effects of T . s . stejnegeri envenomation are tissue swelling, pain, and local ecchymosis. We do not recommend the use of cold packs during first aid to reduce wound pain, as this may be a risk factor for wound necrosis. In addition, patients with bulla or blister formation should be carefully examined for subsequent wound necrosis. Antiplatelet use may worsen systemic bleeding. No severe rhabdomyolysis or renal failure was observed in this large case series, we therefore considered that they were not prominent effects of T . s . stejnegeri bite.

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Section: Discussionmentioning

confidence: 52%

Envenomation by Trimeresurus stejnegeri stejnegeri: clinical manifestations, treatment and associated factors for wound necrosis

Chiang

Tsai

Liu

et al. 2020

J. Venom. Anim. Toxins incl. Trop. Dis

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“…Only three bacterial species recovered from deep tissue or biopsy cultures were also present in the oropharynx swab culture of N. atra, which suggests the requirement of simultaneous determination of both the bite wound and snake oropharynx bacterial microbiota. Given the considerable variability in the incidence of infection in snake bite wounds (1%-81%) [35,36], the causative organisms, and the methods used to isolate a pathogen in variable clinical settings [5,10,27,[37][38][39], an institutional protocol for antibiotic selection during snake bite wound management should be adapted based on the regional microbiology data of both snake bite wounds and snakes.…”

Section: Discussionmentioning

confidence: 99%

An investigation of conventional microbial culture for the Naja atra bite wound, and the comparison between culture-based 16S Sanger sequencing and 16S metagenomics of the snake oropharyngeal bacterial microbiota

et al. 2021

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Naja atra is a major venomous snake found in Taiwan. The bite of this snake causes extensive wound necrosis or necrotizing soft tissue infection. Conventional microbial culture-based techniques may fail to identify potential human pathogens and render antibiotics ineffective in the management of wound infection. Therefore, we evaluated 16S Sanger sequencing and next-generation sequencing (NGS) to identify bacterial species in the oropharynx of N. atra. Using conventional microbial culture methods and the VITEK 2 system, we isolated nine species from snakebite wounds. On the basis of the 16S Sanger sequencing of bacterial clones from agar plates, we identified 18 bacterial species in the oropharynx of N. atra, including Morganella morganii, Proteus vulgaris, and Proteus mirabilis, which were also present in the infected bite wound. Using NGS of 16S metagenomics, we uncovered more than 286 bacterial species in the oropharynx of N. atra. In addition, the bacterial species identified using 16S Sanger sequencing accounted for only 2% of those identified through NGS of 16S metagenomics. The bacterial microbiota of the oropharynx of N. atra were modeled better using NGS of 16S metagenomics compared to microbial culture-based techniques. Stenotrophomonas maltophilia, Acinetobacter baumannii, and Proteus penneri were also identified in the NGS of 16S metagenomics. Understanding the bacterial microbiota that are native to the oropharynx of N. atra, in addition to the bite wound, may have additional therapeutic implications regarding empiric antibiotic selection for managing N. atra bites.

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“…Because of its availability and effectiveness in detecting radiopaque objects, metal objects as an example, plain radiographs are the initial test of choice in the investigation of foreign bodies in the foot [3,[5][6][7]. Organic foreign bodies, like wood, tend not to be radiopaque and usually are negative unless there is a bone reaction [3,5]. In the differential diagnosis, one should always think of chronic osteomyelitis or bone tumors.…”

Section: Discussionmentioning

confidence: 99%

A Child with a Painful Foot: How to Get a Definitive Diagnosis

Kimmenade

Meijer

Hoornenborg³

et al. 2022

Case Reports in Orthopedics

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This case report describes an 8-year-old healthy boy with a retained wooden foreign body in his 4th metatarsal bone of his right foot. He was presented several months after the initial trauma, stepping into a toothpick, had occurred. He was operated in our hospital, and the wooden toothpick was removed. The operation and recovery were both uncomplicated. History and physical examination are essential in these types of cases with a history of penetrating trauma but can be inconclusive due to the delay in presentation. Aggressive treatment on the other hand is necessary to prevent bigger problems such as the development of inflammatory problems and persisting complaints. A thorough, systematic, and complete work-up from the history to treatment is therefore necessary and will be described in this case report.

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Puncture Wounds of the Foot

Cited by 12 publications

References 11 publications

Envenomation by Trimeresurus stejnegeri stejnegeri: clinical manifestations, treatment and associated factors for wound necrosis

Envenomation by Trimeresurus stejnegeri stejnegeri: clinical manifestations, treatment and associated factors for wound necrosis

An investigation of conventional microbial culture for the Naja atra bite wound, and the comparison between culture-based 16S Sanger sequencing and 16S metagenomics of the snake oropharyngeal bacterial microbiota

A Child with a Painful Foot: How to Get a Definitive Diagnosis

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