Authors: (including presenting author): :
(1)Chong HM, (2)Pun MK, (2)Chung CP, (1)Yiu HL
Affiliation: :
(1)Department of Surgery, New Territories West Cluster, (2)Wound Care Team, New Territories West Cluster
Keyword 1: :
Point-of-care ultrasound (POCUS)
Keyword 2: :
Non-healing wound
Keyword 3: :
Foreign body
Keyword 4: :
Wound assessment
Keyword 5: :
Traumatic wound
Introduction: :
Persistent post-traumatic wound healing failure is a significant clinical dilemma that often worsened by underlying comorbidities. Retained foreign body (FB) is one of the causes of such refractory wounds, as it’s occult nature often interfere our wound assessment, leading to delayed wound healing. Point-of-Care Ultrasound (POCUS) has emerged as a versatile, non-invasive imaging device that enables real-time bedside visualization, offering an additional information of wound condition. This case study focuses on a patient with multiple comorbidities and a non-healing traumatic wound, aiming to illustrate how POCUS facilitates our wound care.
Objectives: :
1.To utilize POCUS for the accurate detection and localization of retained FBs in a non-healing wound
2.To guide the removal of the identified FBs and to ensure complete clearance
3.To evaluate the impact of POCUS-guided intervention on shortening wound healing time and reducing unnecessary procedures
Methodology: :
The patient, Ms. Chui, is a 68-year-old female with type II diabetes, hypertension, and asthma. She sustained a right temporal abrasion following a fall on 15 April 2025. Over the next six months, despite multiple emergency department visits, surgical wound exploration, incision and drainage (I&D), antibiotic therapy, and the application of various antimicrobial dressings, the wound failed to heal. Instead, it progressed to form a 1.5cm-deep sinus, accompanied by purulent exudate, with several small (1-3mm) wooden fragments intermittently removed. On 6 October 2025, Ms. Chui was referred to the Cluster Wound Care Nurse Clinic, where POCUS was performed at the bedside to assess the wound sinus. Under real-time ultrasound guidance, iris forceps were used to extract the multiple pieces of wooden fragment, up to 1 cm in size. A post-procedural POCUS scan was conducted to confirm complete clearance. Subsequent wound care involved a simple dressing, the wound healed after 7 days. Pre-arranged follow-up CT verified no FB retention.
Result & Outcome: :
POCUS successfully identified and precisely located multiple retained wooden FBs in the wound sinus, including larger fragments up to 1cm in size that had not been detected during prior interventions. Ultrasound-guided removal ensured the full clearance of all FBs, as confirmed by both post-procedural POCUS and follow-up CT. The patient’s wound, which had remained unhealed for six months, achieved complete healing within one week of the intervention, with no signs of recurrence, infection, or additional complications at the follow-up visit. This outcome demonstrates POCUS enhances diagnostic accuracy for occult FBs, enables targeted interventions, shortens healing time, and reduces the need for unnecessary procedures.
