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Foreign Body Removal (soft tissue)

Checked: 23-11-2022 by Rob Adams Next Review: 23-11-2023

Foreign Body Removal

Please note - The foreign body removal service at Southmead Hospital radiology department is no longer available to GPs via direct referral.

Foreign bodies in skin or soft tissue that do not cause symptoms or irritation can often be left with no clinical sequelae (1) and do not need referral.

If a foreign body is causing significant irritation, infection or other problems and needs to be removed then a referral can be considered - see referral section below.

(1) Foreign bodies (hand) - GP notebook

Referral

The following referral guide has been discussed with NBT plastics department and gives some general advice about best routes of referral for patients who need foreign body removal in both acute and non-acute situations. Please use the feedback button to raise any concerns or issues that arise.

Non- acute management

Referral for non-acute removal of foreign bodies should be considered where they have caused infection, abscesses or are causing significant irritation. The guide below may help decide most appropriate destination:

Foreign bodies in hands / wrists and arms that are symptomatic can be referred to plastics via eRS.
Foreign bodies in feet and over joints in legs and arms that are symptomatic, should be referred to MSK interface service.
Foriegn bodies of the trunk / axilla / groin that are symptomatic should be referred to GI surgeons via eRS.

Acute management

In regard to Foreign bodies with clinical signs of infection/ cellulitis/ abscess that need acute management please consider the following referral routes according to anatomical site:

Limbs - where foreign body/ cellulitis is across a joint (including foreign bodies in ankles and feet)- Refer to orthopaedics at local hospital via on call team.
Limbs - where foreign body/ cellulitis is not across a joint - Refer to Plastics at NBT via on call SHO bleep.
Hands and wrist (all) - Refer to Plastics at NBT via on call SHO bleep.
Head and neck (including face) - Refer to Max fax or ENT at UHBW - via on call team.
Trunk (including axilla, groin, peri-anal) - Refer to GI surgeons at local hospital - see Surgical Emergency Care page.
Breast - Refer to breast clinic at NBT - see mastitis and breast abscess page.
Eye - Please see Corneal Foreign Body page.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.