Soft tissue foreign body

Indications for Removal

1. Potential for inflammation or infection
   1. Vegetative or chemically reactive material
   2. Heavy bacterial contamination (e.g. teeth, soil)
   3. Proximity to fractured bone
   4. Established infection
   5. Allergic reaction
2. Toxicity
   1. Spines with venom
   2. Heavy metals
3. Functional and cosmetic problems
   1. Impingement on nerves, vessels, tendons
   2. Restriction of joint mobility
   3. Proximity to tendons
   4. Impairment of gait
   5. Persistent pain
   6. Cosmetic deformity (e.g., tattooing)
   7. Psychological distress
4. Potential for later injury
   1. Intra-articular location
   2. Intravascular location
   3. Migration toward important structures

Treatment

• antibiotics indicated for organic matter
• do not extend hand wounds in ED

Dispo

• ortho 1-2 days if not retrievable

Source

• Tintinalli