Pictures of infected splinters. Splinter Removal and Foreign Body Treatment: Essential First Aid Guide

06.02.202309.06.2023 by alexxlab

How do you identify and treat an infected splinter. What are the best methods for foreign body detection in the hand. When is professional medical intervention necessary for splinter removal. How can complications from untreated foreign bodies be prevented.

Understanding Splinters and Foreign Bodies in the Hand

Splinters and other foreign bodies lodged in the hand can range from minor nuisances to serious medical concerns. These intrusions often occur during everyday activities, but their impact on health and functionality can be significant if not addressed properly.

Foreign bodies in the hand typically include:

Wood splinters
Metal shards
Glass fragments
Plant thorns
Marine animal spines

The severity of the situation depends on various factors, including the type of material, location in the hand, and the body’s reaction to the intrusion.

Advanced Detection Methods for Foreign Bodies

When visual inspection and manual probing fail to locate a foreign body, medical professionals turn to advanced imaging techniques. These methods provide crucial information about the object’s location, size, and composition.

X-ray Imaging

X-rays are often the first line of detection for foreign bodies. They can reveal:

Metallic objects (copper, iron, aluminum, steel, tin)
Calcium-containing materials (teeth, fish spines)
Some types of gravel, plastics, and glass

However, a clear X-ray doesn’t guarantee the absence of a foreign body, as some materials are not radio-opaque.

Ultrasound Examination

Ultrasound technology offers several advantages in foreign body detection:

Effective for wood, thorns, and other non-metallic objects
Provides information on size, shape, location, and depth
Can detect multiple foreign bodies
Identifies changes in surrounding tissues and potential abscesses
Low-cost and comfortable for patients

Advanced Imaging Techniques

In complex cases, healthcare providers may employ:

Computerized Tomography (CT) scans
Magnetic Resonance Imaging (MRI)

These methods are particularly useful for deep-seated objects or those near bones, though they are more expensive and may be reserved for specific situations.

Factors Influencing Treatment Decisions

The approach to treating foreign bodies in the hand is not one-size-fits-all. Medical professionals consider several factors when determining the best course of action:

Type of foreign material
Location within the hand
Presence and severity of symptoms
Risk of infection

Understanding these factors helps in developing an effective treatment plan tailored to each patient’s unique situation.

High-Risk Foreign Bodies and Infection Potential

Certain types of foreign bodies carry a higher risk of complications and infections. These include:

Plant-based materials (wood splinters, thorns)
Bite wounds from animals or humans
Marine creature spines and spicules

The increased risk associated with these foreign bodies stems from various factors:

Plant materials can introduce bacteria and fungi into the wound
Bite wounds often involve crushed tissue, reducing the body’s ability to fight infection
Marine animal spines may carry toxins or bacteria specific to aquatic environments

Types of Infections

Infections resulting from foreign bodies can be categorized into two main types:

Bacterial infections: These develop rapidly and cause severe symptoms early on
Fungal and atypical mycobacterial infections: These are slower-growing and may not manifest symptoms for weeks or months

The latter type of infection poses significant challenges in diagnosis and treatment, often requiring prolonged medication and multiple surgical interventions.

Inflammatory Responses vs. Infections

Distinguishing between inflammation and infection can be challenging, as both conditions share similar symptoms. Wood slivers and thorns, in particular, can trigger inflammatory responses that mimic infection:

Swelling
Redness
Warmth
Pain

In contrast, synthetic materials like glass, metal, and plastic are less likely to cause inflammation or infection due to their non-biological nature.

Decision-Making in Foreign Body Removal

The decision to remove a foreign body is not always straightforward. Factors influencing this decision include:

Depth of the object
Presence of symptoms
Proximity to vital structures (tendons, nerves, joints)
Risk of further injury

In some cases, small, deep-seated, and non-reactive foreign bodies may be left in place and monitored through regular check-ups. However, objects near sensitive structures or causing persistent symptoms typically require removal.

Indications for Removal

Common reasons for foreign body removal include:

Persistent pain
Suspected or confirmed infection
Risk of damage to surrounding tissues
Interference with hand function

It’s important to note that most symptomatic foreign bodies will not resolve without intervention, as the body rarely breaks down and eliminates these objects on its own.

Medical Procedures and Infection Management

When a foreign body requires removal, healthcare providers follow a systematic approach:

Wound assessment and cleaning
Removal of the foreign body
Specimen collection for potential infection analysis
Antibiotic treatment if necessary

During the removal process, doctors may take a swab of the wound to test for infection. This helps in selecting the most effective antibiotic treatment if an infection is present or suspected.

Antibiotic Selection

The choice of antibiotic depends on several factors:

Type of foreign body
Source of potential infection (e.g., human or animal bite, marine environment)
Common pathogens in the geographic area
Results of wound culture, if available

In some cases, empiric antibiotic therapy may be initiated before culture results are available, based on the most likely pathogens involved.

Advanced Infection Management

More severe infections may require advanced interventions:

Surgical drainage of abscesses
Joint cleansing for infected joints
Debridement of infected tendons and bones
Intravenous antibiotic therapy for several weeks

These aggressive treatments are necessary to prevent long-term complications and preserve hand function.

Complications and Special Considerations

While many foreign body injuries resolve with proper treatment, some can lead to serious complications:

Nerve damage requiring surgical repair
Tendon infections leading to reduced mobility
Bone infections (osteomyelitis) necessitating long-term antibiotic therapy
Chronic pain or reduced hand function

Certain situations require immediate medical attention:

Deep puncture wounds, especially from rusty objects (tetanus risk)
Animal bites, particularly from cats (high infection risk)
Injuries involving joints or tendons
Signs of systemic infection (fever, chills, spreading redness)

Early intervention in these cases can significantly improve outcomes and prevent long-term complications.

Prevention and Self-Care

While not all foreign body injuries can be prevented, some precautions can reduce the risk:

Wearing protective gloves during manual work
Promptly cleaning and inspecting any hand injuries
Seeking medical attention for deep or painful splinters
Keeping tetanus vaccinations up to date

For minor splinters that can be safely removed at home, proper technique is crucial:

Clean the area thoroughly with soap and water
Sterilize tweezers or a needle with rubbing alcohol
Gently remove the splinter, pulling in the direction it entered
Clean the wound again and apply an antibiotic ointment
Monitor for signs of infection

By understanding the risks associated with foreign bodies in the hand and taking appropriate action, individuals can minimize the potential for serious complications and ensure optimal hand health and function.

Splinters and Other Foreign Bodies in the Hand

If you or your doctor cannot confirm the location of a foreign body in your hand, medical technology is another method of finding a foreign body. X-rays are often the first test ordered. Some types of metal that can be seen on x-ray include copper, iron, aluminum, steel, or tin. Materials such as teeth, tooth fragments, and some fish spines include calcium and can be visible on x-rays. Also, most gravel, plastics, coral spicules, and some types of glass may be visible on x-rays. Keep in mind that though x-rays can show some materials, they don’t show all objects, so a normal x-ray does not mean you are in the clear.

Other tests can be ordered if x-rays do not clearly show a foreign body. Performed by an experienced technician, an ultrasound is a very effective, low-cost, and comfortable test that bounces sound waves off the foreign body to create a brighter area on the screen. Wood, thorns, and other materials can be detected with ultrasound. Ultrasound can demonstrate if you are dealing with one or multiple foreign bodies, and this test can also determine their size, shape, location, direction, and depth. Ultrasound can also detect changes in the surrounding soft tissues and whether fluid is present to suggest an abscess.

Computerized tomography (CT) scans and magnetic resonance imaging (MRI) can also show foreign bodies. If the foreign body is deeper or near a bone, a CT may be required. CTs and MRIs are more expensive and may be considered based on the injury location and other patient-specific characteristics.

Many factors determine the treatment of foreign bodies. These include the kind of foreign material, the location, the patient’s symptoms, and the likelihood of infection.

Foreign bodies from plants, bite wounds, and marine creatures are more likely to cause reactions or infections. Bite wounds involve the crushing of tissue and other injury. This lowers the body’s ability to fight bacteria from the wound. Spines and spicules from marine animals can carry poisonous material. Some infections are caused by bacteria, which divide quickly and cause more severe symptoms early. Fungal and atypical mycobacterial infections often are slower-growing organisms, so those might not cause symptoms for weeks or months. These types of infections are much harder to grow in a laboratory to identify the cause of infection, and they are also harder to cure and may require medication for weeks or months, including one or more surgeries.

Wood slivers and thorns may cause inflammation, which makes the area swollen, red, warm, and painful. These symptoms mimic infection, so it can be difficult to separate inflammation from infection. Glass, metal, and plastic are synthetic products, not biologic structures, so they are less likely to cause inflammation and/or infection.

The location of the foreign body can dictate the need for removal. If it is deep, without symptoms, and non-reactive, no invasive treatment may be needed. It may only be followed with occasional office exams to monitor for developing problems. Examples are small pieces of metal or glass. Those close to the skin, tendons, nerves, or joints may be more painful with light pressure and will require removal. This could be due to symptoms or concern about further injury. Sharp glass and metal foreign bodies have caused injuries to vital structures.

Pain or suspected infection are the most common reasons for foreign body removal. Most foreign bodies that cause symptoms do not go away without a procedure. It is rare for the body to be able to break down the foreign body and get rid of it.

During a foreign body removal, the doctor may swab the wound to obtain a specimen and then send it to the lab to determine if an infection is present. Sometimes, the presence of an infection is obvious, and other times, it can be hard to tell just by looking at the wound. When infection is suspected, the doctor may prescribe the patient one or two antibiotics to start based on common organisms in your geographic location. If the wound culture grows bacteria in the lab, this can make picking an effective antibiotic easier.

Bacteria from human, dog, or cat bites often require different antibiotics than a thorn puncture. Microorganisms from marine animals are also very different from land animals. Deeper fluid collections or abscesses need surgical drainage and antibiotics. Infected joints, tendons, and bones require more involved surgeries and sometimes intravenous antibiotics for several weeks. Infected joints are opened and cleansed. Infected tendons and bones require the removal of very infected tissue, as well as pills or intravenous antibiotic medication.

Nerve injuries require exploration and repair because they do not usually heal without surgery. However, when nerve fibers are cut, residual numbness or weakness can be expected, even if the nerve could be repaired. Partial tendon tears can heal without surgery but may develop scarring that can limit motion. Sometimes, therapy alone can improve motion. Other times, a surgery called a tenolysis may be worth trying. Many completely severed tendons have an immediate loss of motion. Early wound exploration can help determine if there is an infection. If no infection is suspected, an early tendon repair can be performed. If an infection is present or suspected, the tendon repair would need to be delayed. When the infection is cured, a late repair can be performed.

Finally, after a puncture wound, a lump can form. This may take months or years to develop. The patient may not remember the puncture. The lump or mass can be tender. The most common post-traumatic mass is an epidermal inclusion cyst. It is thought that some skin cells get driven under the surface and survive. They continue to grow and secrete normal oils and protein, which gradually form a mass. Another post-traumatic mass is a pyogenic granuloma, which is a raised, red lump that easily bleeds. It usually requires removal and cauterization with silver nitrate or another electrocautery.

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand. Find a hand surgeon near you.

Pictures, symptoms, causes, and treatment

A skin abscess or boil is a bump on or below the surface of the skin. Abscesses usually contain pus or clear fluid and can appear anywhere on the body.

Most skin abscesses are harmless and heal on their own. In some cases, however, they require medical intervention.

In this article, we outline the symptoms, causes, and treatments for skin abscesses. We also cover potential complications and when to seek medical care.

A skin abscess looks much like a pimple, but it is larger. It is also usually deeper under the skin.

Abscesses contain pus or clear fluid and typically do not pose a threat to a person’s health. Larger abscesses may require medical intervention, but they are not necessarily dangerous.

However, in some cases, leaving a skin abscess untreated can lead to severe complications.

Skin abscesses can occur all over the body but are common in the following areas on the body:

under the arms
on the lower back
around the genitals and anus

A bump on the skin may be an abscess if it:

is firm yet squishy
is round
contains pus
is painful, swollen, and red
is hot to the touch, which means it is likely infected
features a punctum, a pinpoint opening at the center

People with an infected abscess may also have a fever and swollen lymph nodes.

Abscesses that do not contain bacteria are typically painless and do not show signs of infection.

People can develop skin abscesses for a variety of reasons, but the most common cause is bacterial infection.

The bacteria typically enter the skin through a hair follicle, puncture wound, or cut to the skin. Sometimes abscesses form around a foreign object, such as a splinter or piece of glass stuck in the skin.

Bacteria that can cause abscess infections include:

Staphylococcus aureus (S. aureus), also known as staph
methicillin-resistant S. aureus (MRSA), strains of staph that are resistant to certain antibiotics
Streptococcus pyogenes
Mycobacterium tuberculosis

Other less common causes of skin abscesses are:

anaerobic organisms
fungal infections
viruses
parasites

Some people have a higher risk of developing infected skin abscesses, including:

those with obesity
those who smoke
people with diabetes
people with compromised immune systems
those who use drugs intravenously

If a person has an infected or painful abscess, a healthcare professional will usually drain it of fluid by making an incision. They may administer local anesthetic to numb the skin for this procedure.

They will then flush the cavity with a saline solution. Healthcare professionals typically leave abscesses open to allow any remaining pus to drain out. If an abscess is very deep, a healthcare professional may pack the wound and insert a wick to aid with drainage.

Depending on the type of infection, doctors may prescribe antibiotics. However, the American College of Emergency Physicians recommend avoiding antibiotics in most cases.

At-home care after medical drainage involves slowly removing packed gauze from inside the wound. Sometimes people will need to have a healthcare professional pack the wound multiple times during the healing process.

People should use moist, warm compresses to encourage wound drainage and prevent the abscess from forming again.

It is also possible to treat boils at home using:

a heat pack to increase blood flow and help fight infection
over-the-counter (OTC) medications, such as antibiotic ointments, to soothe the skin, speed healing, and prevent infection
other OTC medications, such as nonsteroidal anti-inflammatory drugs, to help with pain and swelling

People should not try to drain an abscess at home. If a person does this, they risk introducing bacteria into the wound, which can lead to complications.

An infected abscess that a person leaves untreated can spread to the bloodstream and lymph nodes, which can be life threatening. An untreated infection may also lead to gangrene.

Treatment may be difficult in cases where MRSA causes the infection.

If an abscess is due to an infection, a person can take the following steps to help prevent more abscesses from forming in the future:

practicing good personal hygiene, including washing the hands
avoiding using shared equipment and items such as towels to limit transmission of the infection
disposing of bandages and tissues properly
shaving carefully to prevent nicks and cuts on the skin
following a healthful diet
quitting smoking
maintaining a healthful weight

Often, a skin abscess is nothing serious. However, sometimes medical attention is necessary.

People should seek immediate medical attention if they:

have signs of a serious infection, such as fever
experience recurring abscesses
are immunocompromised
have a chronic condition or illness, such as diabetes

While most skin abscesses are nothing to worry about, some may require a healthcare professional’s attention. It is possible to treat a small abscess at home by applying heat to shrink and drain it.

If an abscess is large or infected, a doctor will cut it open to drain the fluid buildup.

If a person suspects they have an infected abscess, they should seek medical attention. Untreated infected abscesses are potentially life threatening, especially if the infection is the result of MRSA.

Historical photos from Chernobyl. The first days after the accident and subsequent mutations

April 26, 2021

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Caution! Some of the photos below may shock you.

Ukrainian photojournalist Igor Kostin was one of the first to photograph the destroyed nuclear reactor at Chernobyl after the accident on April 26, 1986.

Photographs of Kostin, which the Soviet leadership allowed to be published only a few weeks after the accident, were distributed around the world, showing its scale .

Study: children of Chernobyl liquidators do not have additional DNA damage
“Chernobyl” through the eyes of the West: memes and tears
Real “Chernobyl”. Life in the “dead forest”

After the disaster, the photographer often returned to the exclusion zone, and also photographed the terrible consequences that radioactive contamination had on people and animals in Ukraine and Belarus.

Igor Kostin died in 2015 in a car accident. He was 78 years old.

Historical images The BBC received from the photographer’s family.

Photo by Igor Kostin/Law Net

Photo of the helicopter that took part in the liquidation of the accident, taken from another helicopter. The first days after the accident.

Photo by Igor Kostin/Law Net

Pollution monitoring from a helicopter.

Photo by Igor Kostin/Law Net

Conscripts in unreliable protective suits are cleaning the roof of Unit 3.

image copyrightIgor Kostin/Law Net

The protective equipment of emergency responders was often self-made.