Chip Removal Protocol
This interactive tool is designed to support pediatricians in decision making during soft tissue foreign body removal. Navigate through sections to assess the need for imaging, calculate safe anesthesia doses, and review surgical techniques such as deroofing.
1. Material Evaluation
Select the sliver type to see image and visibility recommendations.
Image Sensitivity
Comparison of diagnostic efficacy by modality (Rx vs Echo).
2. Anesthesia Calculator
Lidocaine 1% (without epinephrine) for digital block or local infiltration.
Remember: For fingers (digital lock), do not use epinephrine if there is prior vascular compromise (although recent evidence is more permissive, standard precaution remains).
3. Technique: "Deroofing"
The preferred technique for superficial subepidermal splinters parallel to the skin. Avoid blind incisions.
Local Anesthesia/Block
- Clean the area with chlorhexidine.
- Perform subcutaneous wheal or digital block.
- Wait 5-10 minutes for maximum effect.
- Trick: Apply ice beforehand to reduce pain from the puncture.
4. Discharge Alarm Guidelines
🔴 Signs of Infection
Instruct parents to return if: increased redness (>1cm), heat, pus, or fever >38°C in the next 48h.
🔵 Foot Injuries (Sneakers)
Risk of Pseudomonas. If the splinter went through the rubber sole, monitor closely. In cases of established infection, consider Ciprofloxacin.
🟢 Local Care
Daily wash with soap and water. Keep the dressing dry. It is not necessary to suture small post-extraction defects.