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Posted by Carey Bledsoe, DPM, MS from 22.214.171.124 (lsanca2-ar26-4-46-187-105.lsanca2.dsl-verizon.net) on jueves, febrero 06, 2003 at 21:24:35 :
In Reply to: Help for sea urchin sting posted by Mick from 126.96.36.199 (spider-mtc-tc023.proxy.aol.com) on miércoles, febrero 05, 2003 at 11:03:11 :
On a surfing trip last year my buddy got washed up on some rocks and had over 100 urchin spines in areas that included his hands, elbows, knees, shins and feet. We were at Manzanillo Bay surfing and staying with Dewey at Casa Tortuga.
I am a podiatrist and as such also a foot and ankle surgeon. Here is the scoop. Go to a dermatologist, let him administer some novacaine, and he can tease or gently remove the spine. In the case of my friend John, whom we have sinced nicknamed "urch" we spent 4+ hours removing the spines and now I consider my self an expert. The spines have a texture similar to sandpaper and will not just pull out of skin. The "smashing" technique is barbaric and can lead to further injury and increased risk of infection. Several of the urchin spines in John penetrated all the way through the skin and into the subcutanous fat and I had to use novacaine and tease them out, suturing several deep wounds after cleaning. When I say tease the spines out I mean that the Dr. needs to gently push the tissue around the spine away from the spine so that it can be gently freed up and grabbed. The spines are like sugar cubes and will immediately crush is grabbed forcefully. The standard of care for the treatment of a sea urchin spin is no differen from other puncture wounds and requires removal of the foreign body and thorough cleansing of the wound. Simply, you went to the wrong doc. I wouldn't expect a family pratice or such to have alot of experience doing this. A dermatologist (for the hand) or a podiatrist (for the feet) will not be intimidated and should have problem in doing this. Remember, you can't just pull it out or it will break up into little painful pieces. Using a number 15 blade the surrounding tissue needs to be pushed away and the then, when freed, the spine can be teased out much like a splinter. Fortunately, on the trip I had an ER nurse who was able to help me take care of our friend John. Call me if you need more help. Carey Bledsoe DPM, MS 909-946-6643
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