From the Research
The treatment for a foreign body in the thumb should prioritize removal of the object, with consideration of wound exploration and initial imaging with radiography or ultrasonography before removal, as recommended by the American Family Physician in 2020 1.
Key Considerations
- Wound assessment and removal of the foreign body should be done with adequate analgesia and judicious use of anxiolytics and sedation.
- After removal, wound irrigation with normal saline or tap water is recommended, avoiding antiseptic solutions that may impair healing.
- The patient's tetanus immunization history should be reviewed, and vaccine administered if indicated, as supported by the study on tetanus infection management in 2008 2.
Management Approach
- For superficial foreign bodies, gentle cleansing and removal using sterilized instruments are appropriate.
- For embedded objects, local anesthesia and careful removal with appropriate instruments are necessary.
- The study on sequelae of foreign bodies in the wrist and hand in 2013 3 suggests that expectant management may be considered for retained foreign bodies that are not easily accessible, as the likelihood of persistent symptoms is low.
Post-Removal Care
- Apply antibiotic ointment and cover the wound with a sterile bandage.
- Monitor for signs of infection, including increasing pain, redness, swelling, warmth, or discharge.
- Complete removal is essential to prevent complications such as inflammation, infection, or granuloma formation, especially for wooden splinters and organic materials that pose higher infection risks.