From the Guidelines
The best fish hook removal technique is the string method, which involves looping a piece of strong fishing line or string around the bend of the hook, pressing down on the eye of the hook to disengage the barb, and then quickly jerking the string to pull the hook out along its entry path. This method is preferred because it minimizes tissue damage by following the hook's curved path rather than creating new trauma, and it's typically less painful than other techniques when done correctly. The provided evidence does not directly address fish hook removal techniques, but general principles of sterile technique and careful manipulation of sharp objects can be applied 1. Some key steps to consider when removing a fish hook include:
- Cleaning the area with antiseptic and applying ice to reduce swelling and pain
- For deeply embedded hooks, pushing the hook forward until the barb emerges through the skin, then cutting the barb off with wire cutters and backing the hook out
- If the hook is in a sensitive area like the eye, face, or near major blood vessels, seeking immediate medical attention instead of attempting self-removal
- After successful removal, cleaning the wound thoroughly with soap and water, applying antibiotic ointment, and covering with a bandage
- Watching for signs of infection such as increasing redness, swelling, or pus. It's essential to prioritize minimizing tissue damage and promoting healing to reduce morbidity, mortality, and improve quality of life.
From the Research
Fish Hook Removal Techniques
- The choice of fish hook removal technique depends on the type of fishhook embedded, the location of the injury, and the depth of tissue penetration 2.
- The retrograde technique is the simplest but least successful removal method, while the traditional advance and cut method is most effective for removing fishhooks that are embedded close to the skin surface 2.
- The advance and cut technique is almost always successful, even for removal of large fishhooks 2.
- The string-yank method can be used in the field and can often be performed without anesthesia 2.
- The push-through and cut-off technique is also used for removal of barbed hooks, which should be removed atraumatically with controlled incision over properly anaesthetised skin 3.
Wound Care and Antibiotic Use
- Wound care following successful removal involves extraction of foreign bodies from the wound and the application of a simple dressing 2.
- Prophylactic antibiotics are generally not indicated for uncomplicated soft tissue injury due to fishhooks not involving cartilage or tendons 2, 4.
- However, prophylactic antibiotics suitable for treatment of Aeromonas species should be initiated to prevent complications in cases where the fishhook is removed from the hand or other areas with high risk of infection 3, 5.
- A retrospective analysis found that antibiotic prophylaxis for freshwater-associated fishhook injury did not change outcome regardless of fishhook location or presence of an immunocompromising condition 5.