RETAINED GLASS FOREIGN-BODIES IN WOUNDS - PREDICTIVE VALUE OF WOUND CHARACTERISTICS, PATIENT PERCEPTION, AND WOUND EXPLORATION

A convenience sample of 164 adult patients with 185 glass-caused wound s who presented to an emergency department (ED) and consented to a rad iograph was prospectively studied. The purpose was to determine the ch aracteristics of wounds at high risk for foreign body (FB) and the pre dictive value of patient FB sensation and probing wound exploration fo r FB retention. Retained glass was located in 28 (15%) wounds. Motor v ehicle 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 associa ted with retained FBs (chi(2) analysis). Patients with wounds with gla ss were more likely to have a positive perception of a foreign body (4 1%) 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 radiogr aph was positive for FB. In one of these cases, a 4-mm glass FB was re moved; in the other four, no FB was found. In conclusion, head wounds resulting from motor Vehicle accidents or puncture wounds are more lik ely to harbor retained glass FBs, Patients with glass FB in wounds are more likely to have a positive perception of PR; however, a positive perception has a low predictive value of glass FB. In this series, a n egative wound exploration made the presence of retained FB greater tha n 2 mm less likely but did not rule out the presence of retained glass . Copyright (C) 1998 by W.B. Saunders Company.