Foreign sharp object in the foot: First aid and management.

Have you just stepped on a sharp object like a glass, a needle or small piece of metal nail or plastic. You may have tried to take it out but you couldn’t, or you have taken it out and you still feel pain under the heel.

Am here to answer some of the questions you have about care and management. I will base this article on my knowledge as a diagnostic radiographer and scientific studies to answer some of your questions.

 Have any questions, remarks, or experience to share? Feel free to use the comments section at the end of the article!🙏

Last updated: May 2024. Written by Juliet Semakula, a certified diagnostic radiographer.

Disclaimer: no affiliate links.

In my years of practice as a diagnostic radiographer I have  x-rayed so many patients who have sharp objects such as glass, needles, and plastic stuck inside their feet.

Summary: Such injuries are at a high risk of infection, including organic foreign bodies or dirty wounds. These should be treated with plain water irrigation and complete removal of retained fragments.

Basics:

Stepping on sharp objects such as a glass or needle can be frightening and painful.

The glass or needle can get stuck in your foot skin, sometimes it is very easy to take it out but sometimes you may need medical care to take it out.

A small piece can be less painful but a deep one can be very painful and if not taken care of can lead to other complications.

▶️How do you know if a sharp glass cut is serious?

Some minor sharp object injuries may not cause any pain, but they can turn out to be serious or not.

Some of these objects can be left in the foot and our bodies will naturally get rid of them as it sheds skin. Usually, a small pimple might form around the area as it heals.

 If you present with an infected wound, the possibility of a retained foreign body should be considered. And this makes it serious because your foot can easily be affected with infection.

So you should see a doctor if you are not sure what to do.

▶️What are the symptoms of a sharp object in your foot?

⭕The area may start bleeding straight away after you have stepped on a needle or glass.

⭕You will feel pain when walking.

⭕Feeling like there’s something inside your foot.

⭕Redness around the injury.

⭕You will experience swelling around the area.

▶️Should I go to urgent care for a piece of glass or needle in my foot?

Sometimes you do not need urgent care, you may be able to remove a glass or needle at home by following these steps.

Imaging is not necessary if the foreign body is adequately visible for removal or if it does not require removal.

▶️Steps to help you remove a foreign body in your foot.

1️⃣sterilisation

First you should Clean the injured area. Germs can infect the wound if it’s not clean enough. Use soap and warm water to wash the area. Put rubbing alcohol on the area to kill any other germs.

2️⃣Preparation

Then use tools such as tweezers to pull out the glass splinter. Clean the tweezers by dipping them in boiling water and rinsing them with rubbing alcohol.‌

3️⃣Removal

The tweezers will help you grab the glass if it’s too small for your fingers. Use a clean needle to scrape surrounding skin out of the way.‌

4️⃣After care

Then clean and protect the area after removal. Wash the area with soap and water again. Cover it with antibiotic ointment and a bandage.

This will help to prevent any infection.

▶️ When to see a doctor after stepping on a sharp object.

You may need medical help if you start having the following trouble with your foot where the sharp entered.

♂️When the glass or needle is too deep, and you are unable to get it with tweezers and a needle.

♂️You have taken out the glass, but it’s still painful.‌

♂️You notice redness spreading around the area. 

♂️The area is very inflamed, and you see puss, swelling, this may mean an infection.

♂️You haven’t been able to remove the glass for over 12 hours. 

♂️You can’t move your toes. 

♂️Walking and standing on your foot becomes painful.

♂️You start feeling a fever.

▶️Management of a sharp object inside your foot

First when you go to the emergency department your doctor will request some x-ray imaging to establish the actual spot where the sharp or glass is in your foot.

Computer Tomography (CT) or ultrasound will only be done for treatment options because it provides more detailed imaging than x-ray. Very small pieces of glass are easy to see with a CT scan.

▶️Surgical removal of foreign object (needle, glass or nail) from foot

Removal of foreign bodies in the foot has shown increased success rates and less complications. (Halaas, 2007) 

I have used x-ray in theatre to help doctors remove deep objects. This is done on live screening to help spot the actual spot.

♦️The doctor will use anaesthetic to help reduce your pain. The wound is cleansed before removal is attempted.

♦️ Special tools like forceps are used to pull out the glass from your foot. 

♦️They may also cut the skin around the splinter to make sure they remove it.

♦️ For a needle removal the doctor applies pressure with the thumbs on both sides of the wound to try to extrude the foreign body.

Then x-rays will be taken to confirm that it is fully out.

▶️What happens if a piece of glass is left in the skin?

When you do not take the needle or glass out it can lead to different complications.

The risk of infection is determined by the length of time since the injury occurred, the type of foreign body, whether the wound was clean or dirty, and your health status.

Infection is one of the common complications if you leave the glass or needle in your foot.

Your foot may be affected by cellulitis and MRSA which could be difficult to treat, and it may lead to your foot being amputated.


 A study of traumatic cuts found the risk of infection to be higher in older patients and those with diabetes, and in wounds that were longer, wider, deeper, jagged, with visible contamination, or with a foreign body (Hollander,2001)


Nerve damage or blood vessels can happen if the piece of object reaches deep enough into your foot, and you will find it difficult to walk and balance.

You will continue feeling pain and a delay in healing which will be a discomfort to your dairy activities. The most important way to avoid all these complications is to completely remove the foreign body.

▶️How long does a glass cut take to heal?

Most cuts and scrapes can be treated at home and will heal in about a week or less.

 However, in some cases, they may need medical attention to reduce the risk of infection and speed the healing process.

Each time you change the bandage, look at your skin to check for signs of infection. These include redness that is getting worse or spreading, swelling, or warmth in the area.

 You might see some thin clear or yellow fluid as the wound heals, which is normal.

Most minor wounds heal on their own within 7 to 10 days. It can take two weeks to start walking on your feet. But this will depend on individual bases.

If the needle hits the nerve, it may take months or years to heal. Regular check ups by your healthcare will be to make sure your recovery is on track.

▶️ Do I need to get a tetanus shot if I step on glass?

Yes, you may need a tetanus shot if your injury has a break in the skin, including a small skin puncture, puts you at risk of a tetanus infection.

The bacteria that cause tetanus can enter your body through any wound in the skin, including minor cuts and scrapes, especially those that have obvious dirt or were exposed to soil.

Depending on when your last tetanus shot was, a doctor may recommend getting a booster shot within 48 hours of a nail puncturing your skin, especially if the nail was dirty.


Tetanus prophylaxis is necessary if there is no knowledge or documentation of tetanus immunisation within 10 years, including tetanus immune globulin for the person with a dirty wound whose history of tetanus toxoid doses is unknown or incomplete. (Halaas, 2007)


 

But you should always consult your doctor for any questions.

▶️Can glass shards get into the bloodstream?

It can’t enter the bloodstream because of its size. Even tiny pieces of glass are much too large to enter a microscopic capillary.

 Injecting glass into the blood would cause an embolism and lodge in the lung or brain and cause a stroke or severe breathing problems.

 You have reached the end of this article. I hope I have answered your main questions. I wish you a quick recovery.💁

📚Sources:

McCAIN LR. Surgical removal of foreign object (needle) from the foot. J Am Podiatry Assoc. 1958 Feb;48(2):82. PMID: 13502226.

Halaas GW. Management of foreign bodies in the skin. Am Fam Physician. 2007 Sep 1;76(5):683-8. PMID: 17894138.

Vukmir RB. Medical malpractice: managing the risk. Med Law. 2004;23:495-513

Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa.: Saunders, 2004.

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