FIGURE 130.42 Removal of a fish hook HAIR TOURNIQUET REMOVAL Indications To remove constricting bands of hair or thread Complications Damage to nerves or vascular structures Damage to tendons Damage to corpus cavernosum, corpus spongiosum, clitoris, or urethra Equipment Topical, local, or regional anesthesia materials Scalpel blade with handle no 11 blade Antiseptic solution Fine-tip forceps Blunt probe Fine-tip scissors Magnifying glasses or loupes can be very helpful Procedure Constriction by hair or thread of a digit or penis and occasionally the clitoris occurs most often in the first few months of life but can be seen in older children on occasion On physical examination, a sharp circumferential demarcation is usually apparent Hair tourniquets on digits have been confused with a felon or paronychia Hair tourniquets on a penis have been confused with paraphimosis or balanitis The application of topical lidocaine or other anesthetic cream/gel to the site 30 to 45 minutes before the procedure may provide some pain relief Isolating the band If the hair or thread is not deeply embedded, a blunt metal probe may be used to isolate the constricting band ( Fig 130.43 ) The band is best isolated by placing the probe under the hair or thread on the dorsal aspect of the finger or toe Digital or penile block may be necessary if topical anesthetic does not provide sufficient pain relief Once the band is isolated, it may be cut with a fine-tip scissors or by placing a scalpel blade against the