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The injury should be treated by washing the wound with copious amounts of water; seawater should be used if sterile water is unavailable. The wound, which is very painful, should be cleansed thoroughly, and all foreign material should be removed. The wound site should be soaked in hot water (113°F or 45°C) for 30 to 60 min to inactivate the venom. Surgical débridement may be necessary, and narcotics may be needed for pain. Tetanus prophylaxis may be required, depending on the patient's immunization status. The wound is either packed open or loosely sutured to provide adequate drainage. Failure to treat this sting may result in gas gangrene or tetanus.