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Foreign body removal with the assistance of ultrasound guidance and methylene blue staining in children—a cohort study

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Abstract

Background

Soft tissue foreign bodies (FBs) are very commonly observed in paediatric emergency departments. Not all FBs can be removed effectively, even via open surgery and image intensifier guidance. In the current study, we evaluated the efficiency of FB removal with the assistance of ultrasound (US) and methylene blue (MB) staining.

Methods

We enrolled 80 patients at our clinical center between May 2016 and December 2020. Eleven patients were operated upon with the assistance of US guidance and MB and were defined as group A; the other 69 patients were defined as group B. For the patients in group A, US was first used to locate the FB; MB was then injected next to the FB. Open surgery was subsequently performed. For group B, the FBs were removed by conventional methods. The surgical outcomes were evaluated according to surgical duration, incision infection rates, radiograph exposure times, and FB residue rates.

Results

The average surgery time for group A was 0.35 ± 0.10 hours; the corresponding time was 0.49 ± 0.50 hours in group B and there was a significant difference between the groups (p = 0.032). The radiograph exposure times were 1.33 ± 0.34 in group A and 4.65 ± 1.81 times in group B (p = 0.021).

Conclusions

This study demonstrates that assistance of US and MB staining is a more efficient approach compared with traditional methods for FB removal, and this surgical method can be used effectively for FB removal in children.

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Abbreviations

FBs:

Foreign bodies

US:

Ultrasound

MB:

Methylene blue

CT:

Computed tomography

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Author information

Authors and Affiliations

  1. Orthopedics Department, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People’s Republic of China

    Kai Chen, Menglei Wang & Yuxi Su

  2. Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People’s Republic of China

    Kai Chen, Menglei Wang & Yuxi Su

  3. National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People’s Republic of China

    Kai Chen, Menglei Wang & Yuxi Su

  4. China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2road 136#, Chongqing, 400014, People’s Republic of China

    Kai Chen, Menglei Wang & Yuxi Su

Authors
  1. Kai Chen
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Contributions

YS participated the study and drafted the manuscript. KC and MW collected the clinical data and helped draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yuxi Su.

Ethics declarations

Ethics approval and consent to participate

The ethics committee of the Children’s Hospital of Chongqing Medical University approved the study.

Consent for publication

Informed consent for publication of photographs was obtained from all subjects.

Competing interests

The authors declare no competing interests.

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Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Kai Chen and Menglei Wang are co-first authors and contributed equally to this work

Highlights

1. We increased the scope of the method of foreign body removal.

2. Combination of ultrasound guidance and methylene blue staining is effective.

3. This surgical method can be recommended to orthopedic surgeons.

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Chen, K., Wang, M. & Su, Y. Foreign body removal with the assistance of ultrasound guidance and methylene blue staining in children—a cohort study. International Orthopaedics (SICOT) 46, 1831–1838 (2022). https://doi.org/10.1007/s00264-022-05427-9

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  • DOI: https://doi.org/10.1007/s00264-022-05427-9

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