Foreign body

see Foreign body response.

2012

Scalp wound infections following craniocerebral trauma caused by the Wenchuan earthquake.

A total of 82 patients suffered from scalp trauma in this study, including 52.4% cases (43/82) with wound infections, mostly accompanied by severe foreign body contamination, for which the time of first debridement was significantly delayed. There were 59 strains of infectious pathogenic bacteria. Gram-positive bacteria were the most common organisms found (64.4%), including strains of Staphylococcus aureus (26/59, 44.1%) and strains of Staphylococcus epidermidis (12/59, 20.3%). Gram-negative bacteria accounted for 35.6% of samples: 22.0% (13/59) were strains of Enterobacter cloacae; 5.1% (3/59) were strains of Klebsiella pneumoniae; and 8.5% (5/59) were strains of Serratia rubidaea.

The rate of scalp wound infections following earthquake-induced craniocerebral trauma, which was dominated by Grampositive Staphylococcus aureus infection, has been markedly elevated in recent years. Early debridement and suturing, nutritional support and application of sensitive antibiotics can augment the therapeutic effect 1).

Case reports

A 31-year-old male developed delayed onset of symptoms 4 years after a stab wound to the cervical spinal cord attributed to a plant needle (plant called Mandacaru). Following removal of the foreign body and decompression/excision of scarring at the C34 level, the patient's symptoms resolved.

Surgical excision should be encouraged to remove chronic penetrating foreign bodies to both decompress and untether the spinal cord 2).

1)
Liu J, Ma L, You C. Analysis of scalp wound infections among craniocerebral trauma patients following the 2008 wenchuan earthquake. Turk Neurosurg. 2012;22(1):27-31. doi: 10.5137/1019-5149.JTN.4391-11.0. PubMed PMID: 22274967.
2)
Onishi FJ, Prandini MN, Cavalheiro S. Delayed presentation of spinal foreign body - Case report and review of literature. Surg Neurol Int. 2017 Jul 11;8:143. doi: 10.4103/sni.sni_74_17. eCollection 2017. PubMed PMID: 28781920; PubMed Central PMCID: PMC5523475.