A 25-year-old man presents to you with an injury to his left foot. He was playing in the water at the beach at dusk when he suddenly developed pain and noted a bloody wound on the sole of his foot. He reports being barefoot at the time of the injury. He is uncertain what he stepped on.
His past medical history is remarkable for type 1 diabetes mellitus, which he has had since early childhood. He is uncertain of the date of his previous tetanus immunization. A tetanus booster is administered. The patient’s wound is shown in the image below.
Image.
Which of the following represents the most appropriate management?
- The wound should be explored with the examiner’s finger.
- The wound should be closed with a 4.0 nonabsorbable suture.
- The wound should be copiously irrigated and left open to heal by secondary intention.
- Amoxicillin should be prescribed following repair.
- X-rays are unnecessary because a retained foreign body is unlikely.
This question appears in Med-Challenger Emergency Medicine Review with CME
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