(3) Removal of foreign bodies in the sole of the feet. Assume that foreign
matter has been introduced into the wound along with the foreign body. An example of
such an occurrence would be a nail going into the foot through a rubber sole of a shoe.
You may want to use a magnifying glass to see the foreign body. An ischemic
tourniquet is mandatory when you are exploring the foot for a foreign body. Proceed in
Enlarge the entrance wound, if necessary, with an adequate
(b) Explore the wound carefully by spreading the soft tissue with a
Grasp the foreign body and remove it through the original wound
(d) Irrigate the wound.
(4) Removal of subungual foreign bodies. Removing foreign bodies that are
under a nail may require partial or complete removal of the nail. If the nail or the nail
bed is to be manipulated, you will need a digital block. Here are the techniques for
removing a foreign object from under a nail:
(a) Use a hypodermic needle, bent at the tip. Slide the needle under
the nail, hook the object, and withdraw the object.
(b) Use a 19-gauge hypodermic needle to slide under the nail and
surround the splinter. Bring the needle tip against the underside of the nail to secure
the splinter. Withdraw the needle and splinter as a unit.
(5) Removal of fishhooks. The condition of the fishhook in the body
determines the manner used to withdraw the fishhook. Look at these removal
(a) Infiltrate the area with one percent lidocaine. Force the barb of the
fishhook through the anesthetized skin. Clip off the barb and remove the rest of the
hook along the direction of entry.
(b) Loop a piece of string or fishing line around the balley of the hook
at which the hook enters the skin. Allow about one foot of string for traction. Hold the
shank of the fishhook parallel to and in approximation with the skin by the index finger of
the left hand. When you have disengaged the barb of the fishhook, pull sharply on the
string to remove the hook through the wound entry.