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 Table of Contents  
CASE REPORT
Year : 2015  |  Volume : 43  |  Issue : 2  |  Page : 80-81

Foreign body glass in the forearm following an injury: an incidental finding after 22 years


1 Department of ENT and Head and Neck Surgery, MaxLife Medicos, Guwahati, Assam, India
2 Department of General Surgery, MaxLife Medicos, Guwahati, Assam, India

Date of Submission18-Sep-2014
Date of Acceptance12-Mar-2015
Date of Web Publication3-Jun-2015

Correspondence Address:
Manigreeva Krishnatreya
14, Pragati Path, Mathura Nagar, Guwahati - 781 006, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1415.158062

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  Abstract 

Foreign body in wounds can lead to unnecessary and avoidable morbidity to patients following injuries. We present here a rare case of foreign body in a wound, which was discovered incidentally after 22 years. Nonhealing wounds of the soft tissues without infection should always raise the suspicion of foreign body inside the wound.

Keywords: foreign body, glass, incidental, nonhealing wound


How to cite this article:
Krishnatreya M, Talukdar A. Foreign body glass in the forearm following an injury: an incidental finding after 22 years. Tanta Med J 2015;43:80-1

How to cite this URL:
Krishnatreya M, Talukdar A. Foreign body glass in the forearm following an injury: an incidental finding after 22 years. Tanta Med J [serial online] 2015 [cited 2022 Jul 4];43:80-1. Available from: http://www.tdj.eg.net/text.asp?2015/43/2/80/158062


  Introduction Top


Impaction and penetration of a foreign body into the soft tissues following an injury is a common occurrence after road traffic accidents and also after minor injuries involving various objects. The prime concern to the treating physician is to remove all suspected foreign bodies from the wound before wound closure, or before applying any dressing to the wound. Foreign body inside soft tissues can result in a prolonged and avoidable morbidity to the patients; hence, detection and removal of all foreign bodies from soft tissue of the wound should be the objective of the physicians treating wounds with suspected foreign body inside it.


  Case report Top


A 32-year-old man presented with an injury to the forearm with a blunt object about 2 months back. The injury was superficial and limited to a small area. After about 3 weeks following the injury, blackish discolorations appeared on the skin overlying the injury. The patient had a history of an episode of scant blood mixed discharge from the site. There was no associated history of pain. The patient recounts a history of injury with a glass object 22 years ago at the forearm, at a site 3.5 cm proximal to the present site of injury. On local examination of the wound, there was 1 × 1 cm area of skin with blackish discoloration and ulceration with a very tiny piece of glass embedded on its surface that could be viewed only with magnification. The blackish discoloration was due to the formation of a small scab over the skin adjacent to the ulcer. Review of past medical records revealed that the previous injury, which occurred 22 years back, was a lacerated wound inflicted by glass and that primary repair of the wound was performed, which was followed by wound dehiscence. The wound was again repaired with secondary sutures at that time. The site with the suspected glass piece was explored under local anesthesia, and a foreign body granuloma of 0.5 × 1 cm [Figure 1] with gritty feeling on touch with a scalpel and small pieces of glass inside it were removed along with a small cuff of skin. Primary repair of the wound was performed after thorough cleansing with saline solution and careful aseptic palpation of the soft tissue under the skin to exclude the presence of any remaining foreign body inside the wound. On follow-up after 2 weeks, the primary wound was healed and sutures were removed.
Figure 1: Picture of the foreign body granuloma after removal.

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  Discussion Top


Foreign body injury with glass tends to migrate with growth in children [1] . In the present case, with the growth of the forearm the foreign body migrated to a distance of 3.5 cm from the original site of injury. The recent injury over the site with the glass pieces resulted in exposure of the granuloma and extrusion of the foreign body from the granuloma. The use of computed tomogram and MRI have been advocated for detecting foreign body in the soft tissue [2] , and, in detecting foreign body in the soft tissue of the extremities, ultrasonography is a cost-effective, sensitive, and specific method for the detection of radiolucent foreign body [3] . Moreover, plain radiography is sensitive to detect glass as foreign body in wounds. A thorough saline cleansing of the wound and careful palpation with gloved fingers under absolute aseptic condition is sufficient in most cases to detect remaining foreign body objects such as glass or porcelain in a soft tissue wound. However, this would not be suitable in delayed wounds. A good clinical examination of the wound, including gloved digital palpation and aseptic cleansing of wounds with suspected foreign body, should be carried out before embarking on any radiological examination to support the clinical confirmation of the absence of any foreign body. Nonhealing wounds of the soft tissues without infection should always raise the suspicion of foreign body inside the wound.


  Acknowledgements Top


Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Yoshioka K, Kawahara N, Murakami H, Demura S, Matsuda M, Tomita K. A glass foreign body migrating into the lumbar spinal canal: a case report. J Orthop Surg (Hong Kong) 2012; 20:257-259.  Back to cited text no. 1
    
2.
Pattamapaspong N, Srisuwan T, Sivasomboon C, Nasuto M, Suwannahoy P, Settakorn J et al. Accuracy of radiography, computed tomography and magnetic resonance imaging in diagnosing foreign bodies in the foot. Radiol Med 2013; 118:303-310  Back to cited text no. 2
    
3.
Shrestha D, Sharma UK, Mohammad R, Dhoju D. The role of ultrasonography in detection and localization of radiolucent foreign body in soft tissues of extremities. J Nepal Med Assoc 2009; 48:5-9.  Back to cited text no. 3
    


    Figures

  [Figure 1]


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[Pubmed] | [DOI]



 

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Abstract
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