3 Tie the midpoint of the string or suture around the curve of the fishhook. Securely wrap the other ends several times around your index and middle finger (Fig. 16-1A).

4 Place the involved extremity on a flat surface to provide stabilization. Depress the shank of the hook against the skin with the index finger of your nondominant free hand until it meets resistance. The shaft of the hook is then lifted approximately parallel to the underlying skin by grasping the eye with the thumb and middle fingers (Fig. 16-1B). This maneuver disengages the barb from the subcutaneous tissue.

5 With the shank depressed and the barb disengaged, grasp the string 12 inches from the hook and firmly and quickly jerk the string, with follow-through, in one forceful move parallel to the shank (Fig. 16-1C). Sudden and forceful pulling on the suture is necessary to prevent failure of the technique. Bystanders should stand clear from the flight path, and protective eyewear should be worn. This method is effective and produces no additional wounds.