II. Preparation
- Detach any connected fishing line
- Tape or cut uninvolved hooks
- Clean fishhook insertion site prior to removal
- Topical Povidone-Iodine (Betadine) or
- Hexachlorophene (Hibiclens)
- Administer Local Anesthesia
- Surgeon to wear Eye Protection
III. First-line Technique: Retrograde Technique
IV. First-Line Technique: String-Yank (Stream Technique)
- Indications (do not use on earlobe)
- Small and medium sized fish hooks
- Deeply embedded fish hooks
- Technique
- See preparation above
- Tie fishing line, Suture or umbilical tape onto hook
- Tie at midpoint of bend in hook
- Hold string tightly or attach to Tongue depressor
- Stabilize involved skin against flat surface
- Depress eye or distal shank as in Retrograde Method
- Clear path of fishhook of people
- Give string a firm, quick jerk
- Resources
- String Yank Technique (Image)
- String Yank Technique (YouTube Video)
V. Second-Line Technique: Needle Cover Technique
- Indications
- Large hooks with single barbs
- Barb superficially embedded
- Images
- Technique
- See Preparation above
- Advance 18 gauge needle along entrance of fishhook
- Insert parallel to shank
- Bevel pointing toward inside curve of hook
- Longer edge of needle matches end of hook angle
- Disengage barb by advancing fishhook
- Pull and twist hook so hook point enters needle lumen
- Back the needle and hook together out of the wound
VI. Third-Line Technique: Advance and Cut Technique
- Indications
- Large fishhook
- Fishhook near skin surface
- Advantages
- Highly successful technique
- Disadvantages
- Increased Trauma to surrounding tissue
- Images
- Technique
- See Preparation above
- Advance hook/barb through skin (use needle driver)
- Single Barb
- Cut barb off and back hook through skin
- Multiple Barbs
- Cut off eye of hook and pull hook through skin
VII. Post-operative wound care
- Explore wound for additional foreign bodies
- Do not Suture wound
- Apply antibiotic ointment and bandage
- Tetanus Prophylaxis
- Prophylactic antibiotics indications
- Immunocompromised
- Diabetes Mellitus
- Peripheral Vascular Disease
- Deep wound involving Muscle, tendon or ligament
VIII. References
- Cook (1981) Emerg Med 223 [PubMed]
- Gammons (2001) Am Fam Physician 63(11):2231-6 [PubMed]
- Haynes in Pfenninger (1994) Procedures, Mosby, p.128-32
- Lantsberg (1992) Am Fam Physician 45(6):2589-90 [PubMed]