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Part 10 > Chapter 154 Subcutaneous Foreign Bodies(Metal, Dental Fragments, Glass, Gravel, and Hard Plastic)

著者:Philip M. Buttaravoli and Kevin J. Brochu
 
Abstract
Subcutaneous foreign bodies can be the result of projectile injuries (e.g., grinding metals) or due to falls with subsequent wound contamination. Imaging, location, and removal are discussed, with an emphasis on a balanced approach between risk of removal vs. risk of retention.
 
Keywords
bloodless field
blunt metal probe
foreign body removal
foreign body sensation
glass
gravel
inert foreign body
metal
organic foreign body
palpable foreign bodies
plastic
retained subcutaneous foreign body
Subcutaneous foreign bodies
suspected foreign body
ultrasound-guided techniques
wood

Presentation  
    Small, moderate-velocity metal fragments can be released when a hammer strikes a second piece of metal, such as a chisel. The patient has noticed a stinging sensation and a small puncture wound or bleeding site and is worried that there might be something inside. A BB projectile will produce a more obvious but very similar problem. Another mechanism for producing hard radiopaque foreign bodies is puncturing with glass shards, especially by stepping on glass fragments or receiving them in a motor vehicle collision. Falling onto gravel can also force sharp fragments under the skin through a small puncture wound. Physical findings will show a puncture wound and may show an underlying dark discoloration or a palpable foreign body.
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