How to Remove a Splinter
For superficial splinters, clean the area, sterilize tweezers or a needle, and remove the splinter along its entry angle, then wash the wound and monitor for infection.
Basic Removal Technique
The approach depends on the splinter's depth and orientation in the skin 1:
Superficial Horizontal Splinters
- These are typically visible on inspection or easily palpated 1
- Expose the entire splinter by making an incision along its long axis over the skin surface 1
- Lift the splinter out completely using forceps 1
- This prevents breaking the splinter and leaving fragments behind 1
Subungual Splinters (Under the Nail)
- Cut a V-shaped piece of nail with the point at the proximal tip of the splinter 1
- Grasp and remove the splinter carefully to avoid pushing it deeper into the nail bed 1
- This technique provides direct access without damaging surrounding tissue 1
Timing of Removal
Remove reactive materials like wood, thorns, and vegetative matter immediately before inflammation or infection develops 1. These organic materials trigger more intense inflammatory responses and carry higher infection risk than inert materials 1.
When to Refer
Refer deeper splinters to a specialist when they are 1:
- Located near nerves, tendons, blood vessels, or vital organs 1
- Difficult to localize despite clinical examination 1
- Elusive and require imaging modalities like ultrasound for better localization 1
Advanced Imaging
- Point-of-care ultrasound with waterbath technique can easily locate invisible splinters 2
- This allows for precise removal under local anesthesia 2
Post-Removal Care
After successful removal 3:
- Irrigate the wound with copious amounts of water 3
- Monitor for signs of infection including redness, swelling, warmth, or purulent drainage 1
- Ensure complete removal as retained fragments can cause persistent inflammation 1
Common Pitfalls
- Never attempt to remove deep splinters near critical structures in primary care 1
- Avoid breaking the splinter during removal by exposing its full length first 1
- Do not delay removal of organic material as infection risk increases with time 1
- Ensure the entire splinter is removed, as retained fragments commonly cause ongoing symptoms 1