Working in the A& E Department dead centre in the Mediterranean means
dealing with sea urchin spine injuries and the sunbaked disgruntled tourists
on a daily basis. All the methods mentioned in the article by Ray McGlone
have been used  and proven to be  relatively effective. I personally have my
own criteria for treatment.
Firstly, if the spine tip can be felt with the tip of the finger the easiest
method would be to use a sterile small gauge needle and ease it out.
If no spine can be felt then it is best to be left alone for a day or so and
reviewed. Asmall pleb of pus normally forms around and beneath the spine.
Then after a small incision and gentle pressure the spine exits with the
pus. The wound is then cleaned and covered with a local antibiotic cream and
dressed.
I have yet to see any major complications using these methods.

Jonathan Joslin MD Dip IMC
A& E
Malta


----- Original Message -----
From: RAY McGLONE <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 04, 2000 11:54 PM
Subject: Sea Urchin spines


> 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. &#169; The Lancet Ltd, 1995.
> ----------------------------------------------
> Volume 346(8984)             4 November 1995             p 1240
> ----------------------------------------------
> Sea-urchin injuries
> [Letter To The Editor]
> Laird, Patricia
> Midwood, 14 Martello Road, Canford Cliffs, Poole, Dorset BH13 7DH, UK
>
> ----------------------------------------------
> Outline
> REFERENCES AND NOTES
> ----------------------------------------------
> 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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