Foreign body reactions Discussion
Foreign body reactions in the upper extremity can result in a variety of
problems, including local inflammation, effects of scarring, structural
damage, presence of a mass and infection, among others. Signs of
progressive problems include pain, size increase or attachment to skin or
surrounding structures, ulceration through the skin, or other changes in
biologic behavior. Treatment options include observation, aspiration, or
surgery. Problems may recur, even after surgical excision. In addition,
inflammation thought to arise from foreign bodies may actually be due to
infection, including atypical infections. Atypical infections are
significant in that they may require surgical excision, treatment for
prolonged periods of time with uncommon medications, or both. Such
infections pose a variety of problems, including potentially severe life
and limb threatening complications. Infections may spread deep within the
hand, initially resulting in little outward evidence of a serious problem.
Infections may progress rapidly and spread to other areas of the body.
Permanent functional impairment is common following the course of a deep
hand infection. Because of the potential for long term problems, outpatient
management of hand infections requires absolute patient cooperation in
taking antibiotics, wound care and clinical status monitoring. Outpatient
management requires that the patient seek immediate medical attention if
there are warning signs of progression, including fever, chills, or
progressive worsening of redness, pain or swelling.
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