Lacerations involving glass. The role of routine roentgenograms.
OBJECTIVE
To determine, when evaluating a laceration caused by glass, whether seeing that the bottom of the wound is free of glass eliminates the possibility that glass is present in the wound.


METHODS
Prospective patient series.


METHODS
Two pediatric emergency departments.


METHODS
226 children with lacerations due to glass occurring in a period of 21 months.


METHODS
Consecutive sample.


METHODS
Before obtaining a roentgenogram, the triage nurse or the managing physician visually inspected each wound and recorded whether the bottom of the wound was seen, if glass was seen in the wound, and the length and depth of the wound. Further treatment of the wound was at the discretion of the managing physician.


RESULTS
Glass was seen in the wounds of 10 children on initial inspection. Of the remaining 216 injuries, glass was contained in 12 (21.4%) of the 56 lacerations when the bottom of the wound was not visualized, and in 11 (6.9%) of the 160 lacerations when the bottom of the wound was visualized. There was a significant association between the depth of the wound and an inability to see the bottom of the wound, and deeper wounds were significantly more likely to contain glass. All but one of the lacerations containing glass had a depth of at least 0.5 cm.


CONCLUSIONS
In the population studied, seeing that the bottom of the laceration was free of glass reduced, but did not eliminate, the possibility that glass was present in the wound. In addition, superficial lacerations (less than 0.5 cm) rarely contained undetected glass fragments. We recommended that further investigation concerning the mechanism of injury, the depth of the wound, and the type of glass involved is needed before physicians abandon routine roentgenography for lacerations due to glass.
Avner
J R
JR
Division of Pediatric Ambulatory Care (Emergency Medicine), Municipal Hospital Center, Bronx, NY.
Baker
M D
MD
D002648:Child; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D005898:Glass; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging*