出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/02/06 22:01:15」(JST)
A splinter is a fragment of a larger object, animal spine, or any foreign body penetrating or purposefully injected into one’s body. The foreign body must be within a tissue for a notable amount of time to be considered a splinter. Splinters may cause initial pain through ripping of flesh and muscle, infection through bacteria on the foreign object, and severe internal damage through migration to vital organs or bone over time.
When most people usually think of a splinter, they usually think of wood. There are many types of common splinters other than wood. According to American Association of Family Practitioners (AAFP), common types of splinters are glass, plastic, metal, and spines of animals.[1]
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Generally when one contracts a splinter, they will feel initial pain as the sharp object makes its initial penetration through the body. Through this penetration, the object cuts through the cutaneous layer of the skin, and settles in the subcutaneous layer of the skin, and can even penetrate further down, breaking the sub-cutaneous layer, and settling in muscle tissue, or even bone. Some splinters will remain inter, or unmoving, yet most will continue to migrate through the body, further damaging its surroundings.
A popular belief is that once a splinter is contracted, the effects are only minor, yet according to the U.S. Census, in one year, there were 1,709 reported instances of eye injury due to splinters, causing workers to miss at least one day of work.[2] Many splinters can come from biological sources such as animals and other objects.
According to the AAFP, some of the most common foreign bodies contracted by people fall into two official classes: Biological splinters, and Nonbiological Splinters.[3] Within the class of biological splinters such foreign bodies include bone, fish spines, teeth, and wood. Within the nonbiological class some of the most common splinters contracted by humans are glass, metal, aluminum, fishhooks, pencil graphite, and plastic.
Rarely, one may become infected with splinters from more unusual sources. Common cases of exotic foreign bodies include sea urchins, insect stings, stingray spines, and even grenade shrapnel.
Splinters are often first detected by the person with the splinter in their body. There are many signs that a splinter has entered one’s body.
Many times, if the presence in a body is not known, but only effects are felt, modern technologies will be employed. Depending on the type of foreign body the patient is infected with modern detectors can range from Computed Tomography, Radiography, and Ultrasonography. If manual detection and localization fail, such modern technologies may be utilized accordingly:[4]
There are many medical techniques to safely remove splinters from one’s body. Common medical techniques include the Elliptical Technique and the String Technique.[5] In the elliptical technique the surrounding are of the splinter is sliced in an elliptical formation. From there the flesh in the elliptical are is cut (in the shape of an upside-down cone) and the whole chunk of flesh, containing the splinter is removed. The Needle Cover Technique is limited to fishhook removal. A string is looped around the base of the hook, and as the hook is pressed further into the skin, the string is pulled, allowing the barbs to be unhooked from muscle and follow the path of the rest of the hook out of the body without snagging any additional flesh.[5]
Infection is usually determined by the duration of time that the foreign object remains lodged in the human body. Objects that have included poison, deep penetration, dirt, or bite injuries generally result in a shorter time until infection is notable. According to the AAFP patients that are older, or have diabetes, or have wounds that are longer, wider, more jagged or deeper, have a much higher risk of infection. Simply the easiest way to avoid infection is to completely remove the splinters or foreign body as soon as possible. Though infection is generally the largest complication encountered with splinters, ranging from 1.1 to 12 percent presence, the use of antibiotics in non-bite cases is generally deemed unnecessary by the medical community.[6] Though cases are rare, infection of foreign body wounds can result in cases of tetanus.
One case of tetanus contraction through a splinter was seen in Ohio, 1993. An 80-year-old woman was presented to an ED with dysphagia and a stiff jaw. Not long after a preliminary checkup, a wood splinter was found to have been lodged in her chin for approximately 1 week; the area was erythematous with active purulent drainage. The woman was diagnosed with tetanus, admitted to the hospital, and begun on a regimen of 3,000 units of tetanus immune globulin, tetanus toxoid, and intravenous clindamycin. Despite aggressive treatment, including assisted mechanical ventilation, the patient succumbed to the effects of her primary infection and died 15 days later. The woman had no history of previous tetanus vaccinations despite previous care for a wound and on-going medical attention for hypertension.[7]
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| 拡張検索 | 「splinter hemorrhage」 |