Surgical Removal of Neglected Soft Tissue Foreign Bodies by Needle-Guided Technique

INTRODUCTION: The phenomenon of neglected foreign bodies is a significant cause of morbidity in soft tissue injuries and may present to dermatologists as delayed wound healing, localized cellulitis and inflammation, abscess formation, or foreign body sensation. Localization and removal of neglected soft tissue foreign bodies (STFBs) is complex due to possible inflammation, indurations, granulated tissue, and fibrotic scar. This paper describes a simple method for the quick localization and (surgical) removal of neglected STFBs using two 23-gauge needles without ultrasonographic or fluoroscopic guidance. MATERIALS AND METHODS: A technique based on the use of two 23-gauge needles was used in 41 neglected STFBs in order to achieve proper localization and fixation of foreign bodies during surgery. RESULTS: Surgical removal was successful in 38 of 41 neglected STFBs (ranging from 2–13mm in diameter). CONCLUSION: The cross-needle-guided technique is an office-based procedure that allows the successful surgical removal of STFBs using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin.