I saw a patient today who stood on a sea urchin whilst on a foreign holiday.
The injury had occured 4 days before. She had little in the way of symptoms
and had already removed two spines that had troubled her, so no active
treatment was needed. But I added the picture to our digital library.
However, I'd be interested in views on how you would deal with a similar
problem. I enclose an extract from the Lancet (food for thought)
Regards,
Ray McGlone
A&E Consultant
Lancaster
Laird: Lancet, Volume 346(8984).November 4, 1995.1240
The Lancet
Copyright. © The Lancet Ltd, 1995.
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Volume 346(8984) 4 November 1995 p 1240
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Sea-urchin injuries
[Letter To The Editor]
Laird, Patricia
Midwood, 14 Martello Road, Canford Cliffs, Poole, Dorset BH13 7DH, UK
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Outline
REFERENCES AND NOTES
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Sir - While bathing in Barbados I trod on a sea urchin. Immediately I
experienced
severe pain in the foot which bled and showed bluish discolouration.
Multiple
black spines were clearly deeply imbedded. Fortunately a Barbadian came to
my
rescue. He told me that as a child he had frequently trodden on sea urchins
and
his mother had immediately run hot candle wax on the affected area. This he
proceeded to do for me and within 2 hours the pain was very much less, so
that
by the following day I was able, partly, to bear weight. Had this not been
so, a
second application of wax would have been indicated. By the third day the
wax
was flaking away together with the spines and I was able to resume my
holiday as
normal.
Various immediate treatments have been described, including hot water soaks,
[1,2] application of salicylic acid paste, [3] and crushing the spines in
situ
with a stone followed by bathing the area in fresh urine. [4] Least easy or
successful is the individual removal of the spines, either directly [1] or
under radiographic [5] guidance. The treatment I received is simple,
non-invasive,
and successful and, I feel, shows the value of taking advice from the local
inhabitants.
Patricia Laird
Midwood, 14 Martello Road, Canford Cliffs, Poole, Dorset BH13 7DH, UK
REFERENCES AND NOTES
1. Rosson CL, Tolle SW. Management of marine stings and scrapes. West J Med
1989; 150: 97-100. [Medline Link] [Context Link]
2. Strauss MB, MacDonald RI. Hand injuries from sea urchin spines. Clin
Orthop
1976; 114: 216-18. [Medline Link] [Context Link]
3. Killpack WS. Letter: injury from spines of sea urchins. Lancet 1974; i:
1342.
[Context Link]
4. Falkenberg P. Sea urchin spines as foreign bodies - an alternative
treatment.
Injury 1985; 16: 419-20. [Medline Link] [Context Link]
5. Newmeyer WL. Management of sea urchin spines in the hand. J Hand Surg
1988;
13: 455-57. [Context Link]
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