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Removing A Splinter Without Tears

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Q. What's the best way to sterilize a needle? Every time our five-year-old daughter gets a splinter there is a family argument. My husband insists on waving a lit match under the needle for about 5 seconds. In my family we always dipped the needle in alcohol. Our daughter gets upset when we disagree over this and sometimes refuses to let us remove the splinter at all.

A. We're not sure either technique will sterilize a needle. A few seconds under a match may not be adequate and a quick dip in alcohol is unlikely to kill all germs either. Soaking the needle for 10 minutes would be a safer approach but most people don't have the patience when there is a painful splinter.

Why not try a doctor-recommended home remedy? Russell Copelan, MD, offered the following: cover the splinter with a little patch of salicylic acid plaster, the kind you would use to treat a wart. Some come with adhesive built in, but others need to be held in place with a bandage. Leave it on for 12 hours. It should ease the discomfort and in most cases, the splinter will work its way out after a few days.


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I would always put some camphophenique or Anbesol on the splinter first. It helped numb the skin enough to keep the kid happy while I slipped the splinter out!

I get splinters quite often since I garden and do woodworking. "Digging" immediately with a needle sterilized or not is not the best approach.

The first thing I do is look at the splinter and see if there is enough sticking out to grab with good tweezers. If there is then likelihood of extracting the splinter is very high.

The second thing is to follow the splinter from entry point to the farthest likely end point under the skin. At that area try a firm gentle pressure to see if you can get the splinter to reverse and expose itself for the tweezers and again you have a good chance of extracting the splinter.

Use of a needle is a last resort. I use it to try to get between the splinter and the skin and break as little of the skin as possible in hopes of getting enough clearance for the tweezers again to grab. This works best with shallow angle splinters, splinters at a deeper angle can be more difficult. I often would dress the splinter entry point with triple antibiotic ointment and a band aide and wait as suggested above. The salicylic acid plaster sounds like a better solution that I can now add to my splinter removal techniques.

When I was a boy we'd use either of them, or even wipe with a peroxide-soaked tissue. Nowadays we use an alcohol swab like one would find in a first-aid kit to clean either a needle or a good, sharp knife-point.

Anbusol sounds like a great idea. It should numb it. How about for a burn on a child's fingers? My grandchild burned her fingers on a light bulb yesterday. I used ice followed by an antibiotic but it still hurt. Did not have aloe vera.

Soy sauce is the absolute BEST remedy. You can stock up on the small packs from an Asian fast food place and keep it in the fridge. It relieves the pain immediately, much faster and better than aloe which keeps burning even when applied over and over. Maybe mustard would work, I'll try that next time. Oily substances like butter or neosporin Ointment (cream would be a better choice) actually intensify the heat in the burn wound and are said to "fry" it.

My uncle was a pharmacist, and years ago when we got splinters he would apply Ichthammol Oint 20%, cover with a bandaid. Still works like a charm!

On this site there have been many recommendations for using Soy Sauce for burns. I tried it and it worked beautifully. Poured the soy sauce over the burn, then did it again a couple more times and the pain left immediately (I used Kikkoman's regular soy sauce, not low sodium). There was no scarring, barely a sign of the burn by the next day. Since I'm in my sixties, this may work for a child even faster!
Soy sauce for burns, anbesol for numbing pain.

Doctors need to know about simple numbing. How come they give painful shots to people without numbing first? Even ice will numb (or one of those icy sprays for muscle stretching). Many of my friends receive shots for joint pain in their knees, toes, etc. and it makes them scream. Given the numbing that would be so much less traumatic and they might even want to go back for another injection instead of suffering and fearing the shot. Of course, how could it not help children afraid of pain?

May we learn more compassion in our medical treatments!
Thanks for your comment.

What is that product? Is it available today over the counter?
Thanks!

The question was how to sterilize a needle not how to remove a splinter. Turn your stove burner on high and place the needle in the flame or on the electric calrod element until the needle is red hot. It is now sterile. Let it cool or cool it before use.

I taught preschool for years and one of the best ways I found to get out a splinter was to soak the area in warm, soapy water or with a warm soapy cloth on the area for 10 minutes or so. The pores open up with the warm water and the splinter generally just floats out easily.

The Art and Science of the Splinterectomy

As Submitted to The People’s Pharmacy (Blog)
Joe and Terry Graden
July 8, 2011

I'm a pre-med educated lawyer specializing in medical malpractice cases. The above recommendation comes close to that (med mal) in my opinion. Splinters hurt like Hades and it's easy to remove them safely if you have the right tools, steady hands, keen eyes and know what you're doing. I strenuously recommend against putting on some salve and waiting for the splinters to spontaneously extrude themselves. A splinter in the flesh (just ask the Lion Androcles aided) is a painful affliction also posing the risk of infection if unattended. I recommend immediate removal according to the following procedures and protocols (all of which are outlined and tendered here by a common-sense layman with experience, and not as a doctor or other "officially certified" medical caretaker.) The following procedure is recommended--of course--for the subcutaneous splinters that can't be readily removed with tweezers.

Tools (all of) needed: Hydrogen peroxide, rubbing alcohol, anti-bacterial salve (e.g. Neosporin), stainless steel safety pin or mid-size sewing needle, very small and precision tweezers, an 8 or 10-power jeweler's loupe (magnifying glass that fits either in eye or is attachable to reading or Rx glasses). Jeweler's "loupes" (eye-fitting magnifying lenses) can be obtained at hobby shops, good pharmacies and medical supply stores for a modest price. Failing that, go online and secure them, for example at this site - http://www.telesightmagnifiers.com/id28.html -- eye-fitting loupes or "clip-on" magnifiers. Final small accessories recommended: A few sterile cotton balls and some clean paper towels and/or (clean) sturdy tissue paper.

They (loupes) are essential to this essentially micro-surgical procedure. If there's no jeweler's loupe, you will still need someone to assist by holding an 8 or 10-power magnifying glass over the splintered tissue--and hold it steadily. I don't recommend the standard magnigying glass held by the assistant--unless access to the eye-socket-securing jeweler's loupe is impossible. The best thing is to buy it now. A jeweler's loupe is like a gun - Better to have it and not need it than need and not have it. Don't buy the "loupe" that you have to hold, but rather the "loupe" that fits in your eye or attaches to your glasses, so you can use the magnifying lens "hands free". As you perform the "surgery", you will need your preferred hand to hold and probe with the needle and your other hand to steady the finger, hand or other body area where the splinter is embedded. Finally a very bright light that can be focused on the splinter site and away from the eye of the surgeon.

Prep: Swab the wound site with hydrogen peroxide on cotton for a minute. There is a much greater risk of microbial contamination from your skin and inside the wound site than the sterilized surgical needle, because the splinter was thrust through typically dirty tissue and carried with it the contaminants adhering to the splinter which the splinter dragged in the wound from the skin it pierced. Note that surgery is nearly always indicated because most splinters create anaerobic incubating lesions- that is closed wounds that can harbor and incubate the most dangerous of germs, such as tetanus. The really bad bacteria thrive in environments where oxygen is not present. (That's why I think
the remedy recommended above is simply wrong. Splinters need opening, foreign body removal, wound cleansing, and open-wound healing.)

Procedure: Cleanse the wound site again by swabbing it with the alcohol (on cotton). Finally, take the same cotton ball and place it in a ceramic dish and lighting it with a match or lighter. Place the needle in your thumb and forefinger grip embedding the needle in another cotton ball to insulate your surgical fingers from the heat. Keep the needle in blue cone of the alcohol flame for 20 seconds and every microbe will be killed. Verification of sufficient heat is had when you dim the lamp and see the tip of your surgical needle or pin glow red. If that stainless steel is glowing red, microbes on it are clearly dead. Repeat the same procedure to cleanse and heat the tip of your tweezers, but leave them in the blue flame a full 30 seconds, and don't expect to see the tip turn red in the heat. Place near the operating table a clean paper towel dampened with peroxide on which to lay your needle and tweezers when not in use.

Now you're ready to proceed. If you're working on a child's splinter, I'd recommend an assisting adult to keep the child and his wound site steady in case the child should wince during your probing procedure.

Next, visualize the splinter. Calculate its depth and use common sense in your approach. The point of entry will be the point of removal, and generally this requires "widening the door" (point of splinter entry). Going constantly back and forth from the "door" to the alcohol bottle and back again, it's important to keep your needle clean. Keep dipping it in alcohol and/or alcohol-soaked cotton in order to keep if free of splinter and tissue debris. When you get down and into the splinter, depending on its size, your task is to put, if possible, the splinter in a position to pull it out with the tweezers.
Again, common sense is essential...but common sense is also...generally sufficient. The task is to remove the splinter...completely. Splinters are variously composed. Some are hard and, when the tissue around them is loosened (at the entry site or "door"), the tweezer can easily remove it. Some splinters are of more porous (softer) wood or other material and may come apart when removal is attempted, either because they are soft, or because the channel in which they are embedded has not been sufficiently loosened (widened). That's where the needle and common sense come in.

Take it slow. The slower your movements and probings, the less likely you are to cause your patient pain. Talk to the splintered one and encourage him/her to believe you're going to do everything possible to avoid causing pain and that the purpose of the whole thing is to remove the splinter and remedy the pain. When you hurt the patient, remind the patient of the "no pain no gain" verity.

Keep in mind your purpose -- clearing by widening the channel in which the splinter is embedded so you can remove it. The tissue surrounding the splinter is already wounded, and manipulation of the lesion by the SIDE of the needle as opposed to its point won't cause much pain. So take care to widen the channel of insertion by keeping the needle point pointing at the splinter (and not the tissue channel) as you slide it down and around the channel in which the splinter rests. Gently...slowly, carefully manipulate the needle down and around all sides of the foreign body until you have reached the point where you think you can free it and pull it out.

The PULLOUT can be accomplished in one or both of two ways: If the splinter has enough hardness and integral integrity, you can pull it out by sticking the needle in its side at an angle (the more obtuse, generally the better)...again using common sense and the mechanical skill you utilize when you're cleaning debris from your fingernails. The second method of PULLOUT is of course the tweezers. Make sure that you can pull the splinter without crushing it, because you'd like it to come out in one piece. That's the ideal "outcome". But if it has to come out in pieces, that's OK too. Perfection is not required. Only complete removal is required. You don't want to leave anything--any amount of splinter debris in "the hole", because, again, the hole, when it closes, becomes an incubator for what's inside. The body abhors most foreign bodies even when they are not laden with bacteria, unless those foreign bodies are made of bio-friendly materials (as they use in surgical implants, sutures and prostheses). As a rule-- with splinters--either get it all out or take the patient to the doc and let him do it.

CLOSING AND WRAPPING - When the last (with your ten-power loop and bright light)of the splinter has been removed, you want to flood the hole several times with alcohol and/or peroxide before you wrap. Ideally, the splinter left a generally open channel that's easy to fill with alcohol. If it's a tight hole (because the splinter came out quick and easy with the tweezers), you need to widen it with the needle (disinfected as taught above)all the way to the bottom of the hole, so that before you wrap or bandage, the entire hole has been flushed with antibiotic fluids.

Bandaging - After the wound is cleansed with alcohol, peroxide etc, I'd recommend putting a dab of Neosporin on a Bandaid or other loose-fitting bandage for closure and
post-op hygiene.

Follow-up care- Remove the bandage twice a day cleansing with alcohol and re-applying the Neosporin bandage, each time checking the temperature of the wound and comparing it to the temperature of the skin surrounding the wound at a distance of 2 or 3 inches. You check the temperature of the wound site for infection. The best "thermometer" for checking wound temperature is your lips. To ready your lips for employment as "microbe detectors", sponge clean them with soap and water, then alcohol or peroxide, and do your best to avoid actually kissing (coming into direct contact with) the wound site. Just get your lips within a half or quarter inch from the wound and they will tell you whether there is heat there. Compare the temperature of the wound site to the patient's skin 3 inches away. If there's a significant difference in the relative temperatures (i.e., if the wound site is detectably warmer), then if that situation persists for more than 3 or 4 hours, you need to take the patient to the doc. Otherwise, when you are 48 hours post splinter removal, with no heat, you can chalk the procedure up as a closed case. And the Lion owes Androcles a hug.

Remember folks - I'm a lawyer and not a doctor. I don't guarantee the safety or medical efficacy of anything I've just shared with you, except to assure you I've used the procedures and employed the same standard of care I have just here summarized in the removal of splinters from my own body and those of my family and friends when called upon for the past 3 decades without a negative result, the latest successful "operation" having been performed on me by me just yesterday (July 7, 2011). (It was an exceptionally difficult case--a piece of rotten wood that got embedded under my fingernail. Thank heavens it was stuck in my left hand, leaving my right to perform the "surgery". The xrxxwx splinter came out in about 20 small pieces. Never got to use the tweezers even once. On the second day, a quasi kiss of my left index finger by my lips verifies "no heat" and another successful "splinterectomy".)

Final Tetanus Caveat- As with all piercing wounds, especially those occurring out of doors where splinters are often received, the patient needs to report the event to his physician in order to verify his immunity status with Tetanus. A booster may be in order.

Shared with you through the courtesy and grace of our good friends (Joe and Terri) at the People's Pharmacy by your truly, friendly NC Med/mal attorney, Robert R. Schoch* (336) 887 3119; rschoch@triad.rr.com

I had a splinter in my heel area and used white elmers glue and a bandaid for a few hours and the splinter came out when I pulled off the bandaid...and I thought this wouldn't work.

re: Ichthammol Ointment 20%

Until recently I was able to obtain from WalGreens, now they say it is no longer available, however it is available from several places on-line--just Google Ichthammol

my 6 year old was playing with the neighbor kids well, they decided to slide down a piece of wood my girl slide on her butt, she has quite a few splinters, I was able to pull some out, and I tried glue, but didn't work, the needle thing was out of the question. So any opinions?

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