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* Infection rate of plantar puncture wounds : 6% - 11%
* Infected plantar puncture wounds finds foreign body in 25% of patients.
* Puncture wound and all the wound : Need to rule out foreign body
* X ray detect >90% of radiopaque foreign bodies > 1 mm
* Wood, thorns, and other plant matter, have radiodensities close to that of
soft tissue and cannot reliably be detected
* Wood, thorns, and other plant matter, have radiodensities close to that of
soft tissue and cannot reliably be detected
* Postinjury cellulitis is an indication for imaging to evaluate for a retained foreign body.
感染是 GPC 為主, 但也要小心 Pseudo
Prophylactic antibiotics : first-generation oral cephalosporin,
antistaphylococcal penicillin, or macrolide
Prophylactic antibiotics : first-generation oral cephalosporin,
antistaphylococcal penicillin, or macrolide
For plantar puncture wounds through athletic shoes -> Cover Pseudo
an oral fluoroquinolone with antipseudomonal activity (Ciprofloxacin)
an oral fluoroquinolone with antipseudomonal activity (Ciprofloxacin)
- Joint : Septic arthritis
- Bone : Osteomyelitis
- Cellulitis, abscess, osteomyelitis
- Cellulitis, abscess, osteomyelitis
Needle-Stick Injuries 針扎
High-Pressure Injection Injuries
高壓噴嘴也可能噴到骨折或把異物噴進體內
- Consult hand surgeon
- Prophylactic anti
- Toxoid
- Avoid Digital nerve block
(May increase pressure in finger compartments)
- Risk of subsequent amputation is reduced if surgical debridement within 6hrs
especially in cases of organic solvent
Epinephrine Autoinjector Injuries
Digital ischemia may resolution in 6 -13 hrs
似乎沒有 evidence 按摩, 泡熱水或任何處置有幫助
Subcutaneous phentolamine injection into the affected area is the one
treatment consistently described that rapidly reverses digital ischemia
from accidental epinephrine injection
High-Pressure Injection Injuries
高壓噴嘴也可能噴到骨折或把異物噴進體內
- Consult hand surgeon
- Prophylactic anti
- Toxoid
- Avoid Digital nerve block
(May increase pressure in finger compartments)
- Risk of subsequent amputation is reduced if surgical debridement within 6hrs
especially in cases of organic solvent
Epinephrine Autoinjector Injuries
Digital ischemia may resolution in 6 -13 hrs
似乎沒有 evidence 按摩, 泡熱水或任何處置有幫助
Subcutaneous phentolamine injection into the affected area is the one
treatment consistently described that rapidly reverses digital ischemia
from accidental epinephrine injection
Tintinalli
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