Sea Urchin Treatment

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Does anyone have any experience of treating Sea Urchin spike wounds? My patient stepped on one of these around 6 years ago, got the spike excised under local anesthetic by his GP and has since had what looks similar to a large painful HD at the site, over 2nd MTPJ.

So far I have tried enucleation to see if there has been any spike left in but as this started to get too painful I had to stop. I have another appointment booked to try a deep enucleation with local anesthetic but am worried about causing more harm than good as I have read a few articles about spikes penetrating the joint space so am wondering whether to refer back to GP for an X-ray. Would something so small as this even show up on X-ray?

Any advice would be appreciated!

 

Hi Linda
I have personal experience of sea urchin spines in Halkidiki ,Greece in 1985. I had a few podiatry instruments with me , specifically a scalpel handle and some blades so was able to take the protruding tops off them and level th skin down as far as possible. when i got home i was able to use a tissue nippers to further extract as they gradually emerged . i cannot remember if i applied a dressing. If i did it would have been granuflex to bring them to the surface. Later in my career i came across a forestry worker with pine needles in his foot and used granuflex to bring them to the surface for extraction with a tissue nippers. the technique with a tissue nippers is to grip the needle /urchin spine and then press the tissues downwards making the needle more prominent
Regards
Peter

 

May not be obvious on X-ray but MRI would detect.

Bill Liggins

 

US would be helpful as well

 

Hi used to treat a patient who had a fibrous lession callus on the foot after stepping on sea urchin unfortunately all that worked for this patient was offloading and regular debridement and occasional silver nitrate there will be scar tissue present and will always have callus formation on the area

 

I know someone who had similar treatment for them as verrucae's, that is to freeze them with liquid nitrogen, just like them to bring out the remainder of the sea urchin's spines. Luckily for them, no callus appearing over the old sites, not yet but was done over 30 years ago, so possibly still time to appear.

 

Possibly carefully breaking down the tissue with 60% salicylic acid, using a u'd felt pad would allow deeper access?