Abstract
A convenience sample of 164 adult patients with 185 glass-caused wounds who presented
to an emergency department (ED) and consented to a radiograph was prospectively studied.
The purpose was to determine the characteristics of wounds at high risk for foreign
body (FB) and the predictive value of patient FB sensation and probing wound exploration
for FB retention. Retained glass was located in 28 (15%) wounds. Motor vehicle as
a mechanism of injury (
P = .003), head as a location (
P = .035), and puncture as wound type (
P = .002) were more likely to be associated with retained FBs (
χ
2 analysis). Patients with wounds with glass were more likely to have a positive perception
of a foreign body (41%) than those with no glass (17%) (
P = .005). The positive predictive value of patient perception was 31%; negative predictive
value was 89%. In five cases, wound exploration was negative and subsequent radiograph
was positive for FB. In one of these cases, a 4-mm glass FB was removed; in the other
four, no FB was found. In conclusion, head wounds resulting from motor vehicle accidents
or puncture wounds are more likely to harbor retained glass FBs. Patients with glass
FB in wounds are more likely to have a positive perception of FB; however, a positive
perception has a low predictive value of glass FB. In this series, a negative wound
exploration made the presence of retained FB greater than 2 mm less likely but did
not rule out the presence of retained glass.
Keywords
To read this article in full you will need to make a payment
Subscribe to The American Journal of Emergency Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Detection of glass foreign bodies by radiography.Injury. 1986; 17: 404-406
- Foreign body injuries of the hand.Emerg Med Clin North Am. 1985; 3: 383-390
- Delayed median nerve injury due to retained glass fragments.J Bone Joint Surg. 1985; 67: 382-384
- Soft tissue foreign bodies.Ann Emerg Med. 1988; 17: 1336-1344
- Glass in the hand and foot: Will an x-ray show it?.JAMA. 1982; 248: 1868-1874
- Penetrating injuries: How easy is it to see glass (and plastic) on radiographs?.Br J Radiol. 1985; 58: 27-30
- Detection of soft-tissue foreign bodies by plain radiography, xerography, computed tomography and ultrasonography.Ann Emerg Med. 1990; 19: 701-703
- Radiographic screening for glass foreign bodies—What does a “negative” foreign body series really mean?.Ann Emerg Med. 1990; 19: 997-1000
- Wounds and Lacerations, Emergency Care and Closure.ed 1. Mosby-Yearbook, St. Louis, MO1991
- Lacerations involving glass: The role of routine roentgenograms.Am J Dis Child. 1992; 146: 600-602
- Gluntz SA Primer of Biostatistics. McGraw-Hill, New York, NY1997
- Introduction to biostatistics: Part 3, sensitivity, specificity, predictive value, and hypothesis testing.Ann Emerg Med. 1990; 19: 591-596
- Foreign body retention in glass-caused wounds.Ann Emerg Med. 1992; 21: 1360-1363
- Foreign bodies of the hand.J Hand Surg. 1984; 9: 194-196
- Diagnosis and treatment of retained foreign bodies in the hand.Am J Surg. 1982; 144: 63-67
- Evaluation of soft tissue foreign bodies: Comparing conventional plain film radiography, computed radiography printed on film, and computed radiography displayed on a computer work station.AJR Am J Roentgenol. 1996; 167: 141-144
Article Info
Publication History
Accepted:
August 22,
1997
Received in revised form:
April 2,
1997
Received in revised form:
April 9,
1997
Received:
March 18,
1997
Footnotes
☆Supported in part by a grant from the Missouri Chapter-American College of Emergency Physicians.
☆Presented at the Society for Academic Emergency Medicine Annual Meeting, May 1994, Washington, DC.
Identification
Copyright
© 1998 Published by Elsevier Inc.
