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A foreign-body reaction (FBR) occurs when the body's immune system reacts to an object in tissue such as a stud in an earlobe, a splinter under the skin or even metal shrapnel in soft tissue.

The clinical presentation and management of this reaction is the same as that of an issue such as a soft tissue infection (cellulitis).

People who are diabetic, or have other conditions which compromise their immune systems, should be wary of sustaining trauma to the skin. This is due to their healing times being decreased and the risk of developing infections increases.


The symptoms which can be experienced in an FBR include the following:

  • Redness of the involved area that tends to swell.
  • Tenderness.
  • Pain.
  • Warmth.
  • Skin dimpling due to inflammation and swelling of the skin.


A few issues can occur when a foreign object is present in tissue and causing an FBR. These can include the following:

  • Secondary bacterial infection - normal bacteria found on the skin could cause a secondary infection of the skin, which could be managed with topical antibiotics, or a deeper infection such as cellulitis, which would have to be managed with oral antibiotics or intravenous antibiotics if the condition gets serious.
  • Abscess formation - a prolonged cellulitis can end up causing an abscess to develop, which occurs due to pus accumulating in the persistently inflamed tissue. This would require surgical intervention as an abscess needs to be drained and cleaned out properly.
  • Foreign body granuloma - a foreign body might not cause any further infection but the FBR which occurs around it, in the tissue, causes a granuloma (inflammatory tissue) to develop around the foreign body. Patients report this to appear as a swelling, which may or may not produce any symptoms. If the foreign body granuloma does cause symptoms, which affects the patient's quality of life, then the mass is removed surgically. Most of the time these granulomas are superficial, so the procedure can be done in the doctor's room using a local anaesthetic.


A foreign body getting stuck or implanted in tissue is usually removed surgically, by using a local anaesthetic to numb the affected area, and then a small incision is made to remove the foreign body.

Thereafter, the wound is cleaned, a topical ointment is applied, to prevent a further infection, and it is appropriately dressed to cover the wound. The patient is also given a tetanus injection to avoid contracting this disease. The wound usually isn't sutured if the incised skin's edges approximate together properly, and it should heal well by itself.

In the event that the patient presents with a secondary infection, due to a foreign body being present in the tissue, then these patients would need to be treated with oral or intravenous antibiotics, depending on the severity of the infection. If the infection isn't too severe, then the patient can wait to let the infection resolve and have the foreign body removed afterwards. If the infection is severe or an abscess has formed, then the patient would need to be admitted to have the foreign body removed under general anaesthesia since local anaesthetics wouldn't work effectively enough in tender, inflamed tissue.

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