FB

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FB

Abbreviation for foreign body.

FB

abbr.
1. foreign body
2. freight bill
3. fullback

frequency of breathing

,

fb

The number of spontaneous or machine-generated breaths per unit time.

foreign body

; FB material abnormal to its site of location, promoting a painful and inflammatory rejection response by local tissues; may predispose to local hypergranulation tissue and bacterial infection (see pyogenic granuloma Table 1)
  • endogenous FB e.g. nail spike/edge of nail plate; slough; synovial fluid that has leaked from a traumatized joint capsule; epithelial pearls; Box 1; see inclusion cyst

  • exogenous FB e.g. wood or metal splinters; scraps of wire or hair

Box 1: Treatment of a foreign body
  • Examine: the FB may be a nail spike/splinter, a thorn, a wood splinter, a scrap of metal swarf, a shard of glass, a sea urchin spine, a hair, a small feather

  • The presence of a FB will cause local pain, inflammation and perhaps a degree of local tissue breakdown

  • The patient history will often indicate the nature of the FB

  • Either open at the point of entry, using a sterile blade

  • Or apply Morison's paste under an occlusive dressing for 24 hours, then open at the point of entry

  • Remove the FB, using a fine blade or forceps

  • (Note: Items like thorns can be extruded from soft tissues by applying firm digital pressure to the tissue either side of the foreign body)

  • Assist drainage, and cleanse area by immersion in warm hypertonic saline foot bath

  • Apply a topical liquid or powder broad-spectrum antiseptic, e.g. Betadine

  • Apply a suitable sterile dressing and deflective pad

  • Review in 2-7 days

Table 1: Treatment of local sepsis
MnemonicRationaleTreatment modality
OOperateRemove the cause of the infection where possible, e.g. remove focal hyperkeratosis/foreign body/nail spike
CCleanseIrrigate area/cleanse cavity with Warmasol delivered under pressure from a sterile syringe
HHeatAssist drainage of pus/exudate by applying heat, e.g. immersion in a warm hypertonic NaCl bath
AAntisepticApply a liquid or powder antiseptic (e.g. Betadine)
DDressCover the lesion with a sterile dressing (e.g. sterile gauze; Lyofoam)
RRestImpose rest, e.g. deflective padding; shoe modification; walking cast; crutches, as necessary
AReappointArrange to review case in 24-72 hours
RReviewAt the subsequent appointment, review progress
If resolution has been initiated, continue to treat as above (O-A) and review weekly until healing is complete
If the infection has not improved, arrange for antibiosis, and continue to review and dress until healing is complete
RReferRefer for specialist review via GP: remember, slow-to-resolve infection can characterize undiagnosed diabetes, or other 'at-risk' patient category

Use all normal preoperative procedures; keep infected lesions covered until ready to treat; take a swab for pathology laboratory analysis of any exudate; use a sterile dressings pack; follow the OCH-A-DRARR treatment mnemonic.

'At-risk' patients presenting with infection or patients presenting with acute or spreading infection should be treated using the OCH-A-DRARR protocol, but provided with or referred for immediate antibiosis.

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