Definition

A splinter, or sliver, is a foreign object that penetrates the skin. In Indonesia, it is commonly associated with wood chips embedded beneath the skin's surface.

Causes

Splinters are a common occurrence, typically from wood chips. Other common materials that cause splinters include fragments of glass, metal, or plastic. Additionally, thorns from plants, such as cactus spines, can lead to splinters. This is a frequent experience for many, especially parents.

Risk Factor

Splinters are especially common in children and in those who are frequently outdoors, particularly if they are not wearing shoes.

Symptoms

A splinter is often visible on the skin, typically appearing on the hands or feet. For instance, shortly after touching an aged wooden surface, a small wood splinter can embed in the skin, resulting in pain disproportionate to its size. Similarly, a child playing barefoot in a park may return home complaining of foot pain after stepping on something sharp.

Symptoms of a splinter:

• Most minor, surface-level splinters cause minimal discomfort. However, those embedded more deeply or positioned vertically often hurt when pressed. Splinters in the foot are particularly painful during walking or standing.
• Foreign body sensation: Older children might report a sensation of something lodged in their skin.

Management

For small, painless splinters near the skin's surface, they may work their way out naturally as the skin sheds, or you can wait until they are more accessible before removing them with tweezers. Removing the splinter is essential if it causes pain, especially for organic materials like wood or thorns, which can become infected more quickly than metals or glass. Organic splinters should ideally be removed on the same day. Fortunately, with the right tools and techniques, splinters can be removed easily. Here are some steps for removing a splinter:

1. Clean the area: Begin by washing your hands and the affected area with soap and water, then gently dry it. This reduces the risk of infection.
2. Examine the splinter: Small splinters in hard-to-reach areas may require a magnifying glass and good lighting to better assess the splinter’s size and entry angle.
3. Soak the area (optional): Soaking in warm water before removal may soften the skin, though it is optional. For young children, a brief soak may be sufficient.
4. Use tweezers for removal: For splinters visible at the surface and aligned horizontally, clean the tweezers with an alcohol swab before use. Gently pull the splinter out, following the angle of entry to avoid breaking it into smaller pieces.
5. Use a needle if needed: For deeper splinters without visible edges, a sterilized needle can help bring the splinter to the surface. Under magnification, use the needle to gently pierce the skin on one side of the splinter and expose it. Assistance from another person may be helpful. Once part of the splinter is visible, use tweezers to slowly extract it.
6. Cleaning and Post-Care: Begin by washing the area and applying petroleum jelly. After removing the splinter, clean the site thoroughly with soap and water, then apply an antibiotic ointment or petroleum jelly, such as Vaseline, to reduce the risk of infection. Cover the area with a bandage until it heals completely.

When attempting to extract a splinter, avoid pinching the skin, as this can exert pressure on the splinter, increasing the likelihood of breaking it into smaller fragments.

If you are unable to remove the splinter within 10 to 15 minutes, do not worry. A healthcare provider can assist in its safe removal.

Several alternative methods may facilitate splinter removal with minimal discomfort, such as:

• Sticky plaster: For small, shallow splinters, apply a sticky plaster over the affected area and gently peel it away to help pull out the splinter.
• Epsom salts: Dissolve Epsom salts in warm water to help ease the splinter out. The salt solution can encourage small splinters to move closer to the surface. Soak the area in this solution for about 10 minutes.
• Honey: Known for its natural antiseptic properties, honey can assist with splinter removal. Apply a small amount of manuka honey over the splinter, cover it with a bandage, and leave it overnight. The honey helps soften the skin, easing the splinter’s removal.

If a child has a splinter, it’s essential to ensure they are up-to-date on vaccinations to prevent possible infections. Immunizations should generally be given at 2 months, 4 months, 6 months, 15-18 months, and 4-6 years of age, followed by a booster every 10 years.

Complications

While splinters rarely cause severe complications, they can lead to infection, especially if deeply embedded or if the object is organic.

Prevention

To avoid splinters, take the following precautions:

• Avoid rough wooden surfaces.
• Wear shoes when engaging in outdoor activities.
• Wear shoes while cleaning up broken glass.
• Keep clear of thorny plants.

When to See a Doctor?

Though most splinters can be removed at home, medical help may be necessary under certain circumstances. Consult a healthcare provider if:

• The splinter is particularly large.
• The splinter is near the eye, inside the eye, or under a nail bed.
• Signs of infection, like redness, crusting, or yellowish discharge, are visible.
• The splinter is embedded vertically, which may require professional tools for safe removal.
• The splinter is deeply embedded or damaged from removal attempts.
• You have been trying to remove the splinter for over 10–15 minutes without success.
• Your child has not received a tetanus vaccination.
• A fever is present.
• Severe pain is experienced.

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