Surgical Management of Retained Sea Urchin Spines Following Multiple Puncture Wounds: A Case Report

Authors

• Michael A. Higham, The University of Texas Rio Grande Valley School of Podiatric MedicineFollow
• Stephanie N. Campbell, The University of Texas Rio Grande Valley School of Podiatric MedicineFollow
• Tyreen Heybeck, The University of Texas Rio Grande Valley School of Podiatric MedicineFollow
• Naomie Jean, The University of Texas Rio Grande Valley School of Podiatric MedicineFollow
• Amanda Killeen, The University of Texas Rio Grande Valley School of Podiatric MedicineFollow

Document Type

Poster

Publication Date

9-26-2026

Abstract

Introduction: Sea urchin spine injuries are uncommon marine envenomation injuries that can result in retained foreign bodies, local inflammatory reactions, and persistent symptoms requiring surgical management in select cases. Initial management should include oral analgesia, hot-water immersion, removal of visible spines, and tetanus prophylaxis when indicated. Granuloma formation is a recognized response to retained spines and may ultimately require surgical excision. Pedicellariae, which possess venom and neurotoxic components, may contribute to envenomation.

Aim: To present a case of multiple deep sea urchin spine puncture wounds with retained foreign bodies.

Case Presentation: We report a 20-year-old Caucasian male who sustained multiple sea urchin spine puncture wounds with retained spines bilaterally. Clinical and radiographic evaluation identified approximately 50 total retained spines. The patient underwent operative exploration two days after initial evaluation. Warm saline tumescence was used during the procedure, and fluoroscopy was used to triangulate the location of retained spines. The retained spines were located deep within the soft tissues at approximately the level of the plantar fascia. A total of 48 spines were removed.

Results: Two weeks postoperatively, the patient reported general sensitivity of the feet rather than pain. At two months following surgery, sensitivity persisted in the left heel. A 6-mm retained spine was subsequently identified and removed in clinic from the symptomatic area.

Conclusions: Sea urchins are echinoderms whose calcitic spines may undergo degradation over time, potentially becoming less radiographically apparent despite remaining as retained foreign bodies. Most spines do not require removal; however, increasing foreign-body burden may produce greater inflammatory reactions, particularly with numerous retained spines. Early evaluation, appropriate intervention, and continued postoperative observation can improve the management of these traumatic injuries.

Recommended Citation

Higham, Michael A.; Campbell, Stephanie N.; Heybeck, Tyreen; Jean, Naomie; and Killeen, Amanda, "Surgical Management of Retained Sea Urchin Spines Following Multiple Puncture Wounds: A Case Report" (2026). School of Podiatric Medicine Publications. 145.
https://scholarworks.utrgv.edu/sopm_pub/145

Academic Level

faculty