Puncture Wounds

What is a puncture wound?

A puncture wound is when the skin has been completely punctured by an object that is pointed and narrow, such as a nail. The wound is not wide enough to need stitches.

Because puncture wounds usually seal over quickly, there is a greater chance of wound infection with this type of skin injury. Puncture wounds of the upper eyelid are especially dangerous and can lead to a brain abscess. A deep infection of the foot can begin with swelling of the top of the foot 1 to 2 weeks after the puncture. Another risk is tetanus if your child is not immunized against tetanus. A child with a puncture wound in the eye, foot, or stomach should always be seen by a healthcare provider.

How can I take care of my child?

• Cleansing. Soak the wound in warm water and soap for 15 minutes. Scrub the wound with a washcloth to remove any debris. If the wound rebleeds a little, that may help remove germs.
• Trimming. Cut off any flaps of loose skin that cover the wound and interfere with drainage or removing debris. Use fine scissors after cleaning the scissors with rubbing alcohol.
• Antibiotic ointment. Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Resoak the area and reapply antibiotic ointment every 12 hours for 2 days.
• Pain relief. Give acetaminophen (Tylenol) or ibuprofen (Advil) for any pain.

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

• Dirt in the wound remains after you have soaked the wound.
• The tip of the object could have broken off in the wound.
• The wound is very deep.
• The sharp object or place where the injury occurred was very dirty (for example, a barnyard).
• The wound looks infected (redness, streaks, pus).

Call during office hours if:

• It has been at least 5 years since your child last had a tetanus booster.
• Pain, redness, or swelling increases after 48 hours.
• You have other questions or concerns.

Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.