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A few weeks ago, the parents of two young children brought their kids into the clinic for removal of multiple wood splinters in their feet. I thought I’d discuss some different types of splinters and some techniques that you can use at home to remove them. In addition, it’s important to know when to come into the medical clinic for help with that process.
Splinters are actually very common, and children and adults come into the clinic usually with a small foreign body embedded into the superficial or subcutaneous soft tissues of the hands or feet. Wood, glass and metallic splinters are the most common types. Many splinters can be removed at home by our patients, which leaves the physicians only the deeper and larger splinters or retained splinters that have been broken down during an attempt at removal. If splinters are not removed completely, they may cause complications such as infection and inflammation.
When to see a medical provider: I recommend that you see a medical provider instead of trying to remove the splinter yourself if there is lots of redness around the splinter, increased swelling or pus draining from the wound.
The severity of the reaction and type of reaction that the body has to a particular splinter. Some examples of reactions to retained foreign materials include:
1) Glass – Mild reaction and the body attempts encapsulation
2) Blackthorns – Severe reaction with inflammation from the plant alkaloids
3) Wood – Severe reaction with inflammation from the oils and resins
4) Cactus Spines – Moderate to severe reaction from the fungal coating on the plant and possibly an allergic reaction
5) Rose thorns – Moderate to severe reaction with inflammation from the fungal coating on the plant
6) Sea urchins – Moderate to severe reaction with inflammation and possible infection
7) Metal – Mild reaction and the body attempts encapsulation
8) Plant spines – Mild to severe reaction from the toxins in the plant
9) Animal spines – Mild to severe reaction from the toxins in the animal spines
10) Plastic – Mild reaction and the body attempts encapsulation
Sometimes splinters can be difficult to detect, especially if they are deep or very small. Clues that a splinter is present might be swelling, tenderness, a mass, or soft tissue infection such as cellulitis, or an abscess. Sometimes we might use a diagnostic test such as a x-ray, ultrasound, CT scan or MRI to detect a splinter if it’s deep and difficult to see.
Removal: We try to remove splinters quickly before inflammation or infection occurs. There are several ways to remove a splinter, some of those might include:
1) Using tweezers: Make sure you have the right kind of tweezers. The sharp tipped splinter tweezers work best most of the time. If the sliver is sticking out of the skin, clean the pair of tweezers with alcohol and carefully pinch the sliver as close to the skin as possible and gently slide it out.
2) Use a small needle: If the sliver isn’t sticking out of the skin, often a needle can help push the sliver out. First clean the needle with alcohol and then push the sliver from the bottom (the pointed end that entered the skin first) and angle upward toward the puncture hold in the skin’s surface. Try to start at the bottom of the sliver so you don’t break it and leave sliver shreds in the skin.
3) Use a razor blade to make a small slice in the skin over the sliver: If the sliver is deep and using tweezers or a needle isn’t working well, you can clean a razor blade in alcohol and make a shallow incision parallel to the sliver, just above it. I know this sounds scary, but the top layer of skin is made of dead skin cells that do not have nerves, so this is not likely to hurt unless you cut too deeply. Once the incision is made, gently part the skin and pick out the sliver.
4) Clean the wound: Whatever method you use to remove the sliver, make sure you clean the wound with soap and water after the sliver is removed. Puncture wounds are often laced with bacteria and are very likely to become infected.
5) Antibiotics: Apply a small amount of antibiotic ointment such as bacitracin over the puncture wound.
6) Examine the area at least once a day for the next several days to look for increasing redness, swelling or pain. If any of these occur, I recommend that you see a medical provider because this might be the start of an infection.
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO