Fishhook injury - Revision history

Blsimpso at 13:23, 29 June 2021

2021-06-29T13:23:32Z

← Older revision		Revision as of 13:23, 29 June 2021
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	[[Category:Trauma]]		[[Category:Trauma]]
	[[Category:Procedures]]		[[Category:Procedures]]

			==External Links==

			===Videos===
			{{#widget:YouTube\|id=YyymouV8ulU}}

			==References==

Hoxbox: /* Incision Technique */

2021-01-08T09:49:57Z

Incision Technique

← Older revision		Revision as of 09:49, 8 January 2021
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	#A hemostat may be used to prevent the hook from snagging additional tissue.		#A hemostat may be used to prevent the hook from snagging additional tissue.
	'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.		'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.

			===Antibiotics===
			Following is from article on Fish Hook Removal from Don't Forget the Bubbles. <ref>Cliona Begley. Fish hook removal, Don't Forget the Bubbles, 2021. Available at: https://doi.org/10.31440/DFTB.29788</ref>

			:''No clinical trial to date has addressed the need for empirical antibiotics in fishhook wounds. In general, empirical antibiotics are prescribed.''

			:''If the hook was not contaminated, empiric antibiotics for skin flora is recommended. Treat as if there might be uncomplicated cellulitis and follow local guidelines.''

			:''If the hook was contaminated, consider other pathogens including Aeromonas, Edwardsiella tarda, Vibrio vulnificus and Mycobacterium marimun. Use an oral first-generation cephalosporin or, in patients with acephalosporin allergy, oral clindamycin, plus an oral fluoroquinolone such as levofloxacin. If there is seawater exposure, add doxycycline to cover for Vibrio (although avoid in children under 8 as it causes teeth discolouration and enamel hypoplasia). If there was soil contamination or exposure to sewage-contaminated water, add metronidazole to cover for anaerobes, unless you are already using clindamycin.''

	==See Also==		==See Also==

Neil.m.young at 02:04, 30 December 2015

2015-12-30T02:04:04Z

Neil.m.young at 02:03, 30 December 2015

2015-12-30T02:03:32Z

← Older revision		Revision as of 02:03, 30 December 2015
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	#'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.		#'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.

			==See Also==
			*[[Laceration repair]]
			*[[Fingertip laceration]]
	[[Category:Trauma]]		[[Category:Trauma]]
	[[Category:Procedures]]		[[Category:Procedures]]

Rossdonaldson1 at 20:37, 22 September 2014

2014-09-22T20:37:17Z

← Older revision		Revision as of 20:37, 22 September 2014
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	[[Category:Trauma]]		[[Category:Trauma]]
	[[Category:~~Procedure~~]]		[[Category:Procedures]]

Rossdonaldson1 at 01:44, 19 September 2014

2014-09-19T01:44:13Z

← Older revision		Revision as of 01:44, 19 September 2014
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	#A hemostat may be used to prevent the hook from snagging additional tissue.		#A hemostat may be used to prevent the hook from snagging additional tissue.
	#'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.		#'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.

			[[Category:Trauma]]
			[[Category:Procedure]]

Gottlima: /* Simple Retrograde Technique */

2014-07-28T20:58:38Z

Simple Retrograde Technique

← Older revision		Revision as of 20:58, 28 July 2014
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	#Press the external portion of the hook toward the skin to disengage the barb.		#Press the external portion of the hook toward the skin to disengage the barb.
	#Slowly back the hook out of the skin.		#Slowly back the hook out of the skin.
	#Note: If the barb catches on skin fibers, other techniques must be used.		#'''Note:''' If the barb catches on skin fibers, other techniques must be used.

	===String-Pull Technique===		===String-Pull Technique===

Gottlima: /* Removal Techniques */

2014-07-28T20:58:24Z

Removal Techniques

Gottlima: Created new Fishhook Injury Page

2014-07-28T20:47:51Z

Created new Fishhook Injury Page

New page

==Background==
*Most commonly involve the hand, head, or face.
*Can be problematic to remove due to the large barb.
*Risk of retained foreign body if bait present on fishhook.

==Removal Techniques==
===Simple Retrograde Technique===
1. Press the external portion of the hook toward the skin to disengage the barb.
2. Slowly back the hook out of the skin.
Note: If the barb catches on skin fibers, other techniques must be used.

===String-Pull Technique===
1. String or suture is tied along the curve of the hook.
2. Press the external portion of the hook toward the skin to disengage the barb.
3. Rapidly pull the string in the opposite direction to remove the hook.
Note: This technique is associated with increased risk of tissue injury, increased pain, and may cause injury to health care providers from the flying hook. Therefore, this technique is rarely used in actual practice.

===Needle-Cover Technique===
1. An 18-guage needle is inserted through the skin alongside the shank of the hook.
2. The needle is advanced over the barb and the entire unit is reversed out.
Note: This technique requires great dexterity and is the least successful overall.

===Advance and Cut Technique===
1. Advance the hook forward until the edge (including the barb) have exited the skin.
2. Cut the barb outside of the skin.
3. Reverse the hook out of the skin.
Note: This method causes additional trauma and contamination (due to fishhook advancement) and is probably only warranted when the needle is already nearly exiting the skin.

===Incision Technique===
1. Using a #11 scalpel, enlarge the entrance wound 2-3 mm along the length of the hook until the barb is disengaged.
2. Slowly reverse the hook out of the skin.
3. A hemostat may be used to prevent the hook from snagging additional tissue.
Note: This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.

← Older revision		Revision as of 02:04, 30 December 2015
Line 8:		Line 8:
	#Press the external portion of the hook toward the skin to disengage the barb.		#Press the external portion of the hook toward the skin to disengage the barb.
	#Slowly back the hook out of the skin.		#Slowly back the hook out of the skin.
	#'''Note:''' If the barb catches on skin fibers, other techniques must be used.		'''Note:''' If the barb catches on skin fibers, other techniques must be used.

	===String-Pull Technique===		===String-Pull Technique===
Line 14:		Line 14:
	#Press the external portion of the hook toward the skin to disengage the barb.		#Press the external portion of the hook toward the skin to disengage the barb.
	#Rapidly pull the string in the opposite direction to remove the hook.		#Rapidly pull the string in the opposite direction to remove the hook.
	#'''Note:''' This technique is associated with increased risk of tissue injury, increased pain, and may cause injury to health care providers from the flying hook. Therefore, this technique is rarely used in actual practice.		'''Note:''' This technique is associated with increased risk of tissue injury, increased pain, and may cause injury to health care providers from the flying hook. Therefore, this technique is rarely used in actual practice.

	===Needle-Cover Technique===		===Needle-Cover Technique===
	#An 18-guage needle is inserted through the skin alongside the shank of the hook.		#An 18-guage needle is inserted through the skin alongside the shank of the hook.
	#The needle is advanced over the barb and the entire unit is reversed out.		#The needle is advanced over the barb and the entire unit is reversed out.
	#'''Note:''' This technique requires great dexterity and is the least successful overall.		'''Note:''' This technique requires great dexterity and is the least successful overall.

	===Advance and Cut Technique===		===Advance and Cut Technique===
Line 25:		Line 25:
	#Cut the barb outside of the skin.		#Cut the barb outside of the skin.
	#Reverse the hook out of the skin.		#Reverse the hook out of the skin.
	#'''Note:''' This method causes additional trauma and contamination (due to fishhook advancement) and is probably only warranted when the needle is already nearly exiting the skin.		'''Note:''' This method causes additional trauma and contamination (due to fishhook advancement) and is probably only warranted when the needle is already nearly exiting the skin.

	===Incision Technique===		===Incision Technique===
Line 31:		Line 31:
	#Slowly reverse the hook out of the skin.		#Slowly reverse the hook out of the skin.
	#A hemostat may be used to prevent the hook from snagging additional tissue.		#A hemostat may be used to prevent the hook from snagging additional tissue.
	#'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.		'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.

	==See Also==		==See Also==

← Older revision		Revision as of 20:58, 28 July 2014
Line 6:		Line 6:
	==Removal Techniques==		==Removal Techniques==
	===Simple Retrograde Technique===		===Simple Retrograde Technique===
	1. Press the external portion of the hook toward the skin to disengage the barb.		#Press the external portion of the hook toward the skin to disengage the barb.
	2. Slowly back the hook out of the skin.		#Slowly back the hook out of the skin.
	Note: If the barb catches on skin fibers, other techniques must be used.		#Note: If the barb catches on skin fibers, other techniques must be used.

	===String-Pull Technique===		===String-Pull Technique===
	1. String or suture is tied along the curve of the hook.		#String or suture is tied along the curve of the hook.
	2. Press the external portion of the hook toward the skin to disengage the barb.		#Press the external portion of the hook toward the skin to disengage the barb.
	3. Rapidly pull the string in the opposite direction to remove the hook.		#Rapidly pull the string in the opposite direction to remove the hook.
	Note: This technique is associated with increased risk of tissue injury, increased pain, and may cause injury to health care providers from the flying hook. Therefore, this technique is rarely used in actual practice.		#'''Note:''' This technique is associated with increased risk of tissue injury, increased pain, and may cause injury to health care providers from the flying hook. Therefore, this technique is rarely used in actual practice.

	===Needle-Cover Technique===		===Needle-Cover Technique===
	1. An 18-guage needle is inserted through the skin alongside the shank of the hook.		#An 18-guage needle is inserted through the skin alongside the shank of the hook.
	2. The needle is advanced over the barb and the entire unit is reversed out.		#The needle is advanced over the barb and the entire unit is reversed out.
	Note: This technique requires great dexterity and is the least successful overall.		#'''Note:''' This technique requires great dexterity and is the least successful overall.

	===Advance and Cut Technique===		===Advance and Cut Technique===
	1. Advance the hook forward until the edge (including the barb) have exited the skin.		#Advance the hook forward until the edge (including the barb) have exited the skin.
	2. Cut the barb outside of the skin.		#Cut the barb outside of the skin.
	3. Reverse the hook out of the skin.		#Reverse the hook out of the skin.
	Note: This method causes additional trauma and contamination (due to fishhook advancement) and is probably only warranted when the needle is already nearly exiting the skin.		#'''Note:''' This method causes additional trauma and contamination (due to fishhook advancement) and is probably only warranted when the needle is already nearly exiting the skin.

	===Incision Technique===		===Incision Technique===
	1. Using a #11 scalpel, enlarge the entrance wound 2-3 mm along the length of the hook until the barb is disengaged.		#Using a #11 scalpel, enlarge the entrance wound 2-3 mm along the length of the hook until the barb is disengaged.
	2. Slowly reverse the hook out of the skin.		#Slowly reverse the hook out of the skin.
	3. A hemostat may be used to prevent the hook from snagging additional tissue.		#A hemostat may be used to prevent the hook from snagging additional tissue.
	Note: This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.		#'''Note:''' This is an excellent technique with great success, but caries the risk of additional neurovascular injury from the incision.