Chan Christina, Salam Gohar A
Michigan State University College of Human Medicine, Department of Family Practice, East Lansing, Michigan, USA.
Am Fam Physician. 2003 Jun 15;67(12):2557-62.
Splinter injuries are common, but larger and deeper splinters are often difficult and painful to remove at home. These splinters often present as a foreign body embedded in the superficial or subcutaneous soft tissues. Whenever possible, reactive objects like wood, thorns, spines, and vegetative material should be removed immediately, before inflammation or infection occurs. Superficial horizontal splinters are generally visible on inspection or easily palpated. A horizontal splinter is exposed completely by incising the skin over the length of the long axis of the splinter, and removed by lifting it out with forceps. A subungual splinter may be removed by cutting out a V-shaped piece of the nail. The point of the V is at the proximal tip of the splinter, which is grasped and removed, taking particular care not to push the splinter further into the nail bed. Removal of an elusive splinter can be challenging and may require the use of imaging modalities for better localization. Deeper splinters, especially those close to important structures such as nerves, tendons, blood vessels, or vital organs, should be referred for removal.
碎片伤很常见，但较大且较深的碎片通常在家中很难取出，还会很疼。这些碎片常表现为嵌入浅表或皮下软组织的异物。只要有可能，像木头、刺、棘和植物材料等有反应性的物体应在炎症或感染发生前立即取出。浅表的水平碎片通常在检查时可见或很容易摸到。通过在碎片长轴方向切开皮肤将水平碎片完全暴露出来，然后用镊子将其取出。指甲下的碎片可以通过切除一块呈V形的指甲来取出。V形的尖端位于碎片的近端，抓住并取出碎片时要特别小心，不要将碎片进一步推入甲床。取出难以捉摸的碎片可能具有挑战性，可能需要使用成像方式进行更好的定位。较深的碎片，尤其是那些靠近神经、肌腱、血管或重要器官等重要结构的碎片，应转诊取出。
