Main Line Pediatrics

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Puncture Wound

Is this your symptom?

  • Skin is punctured by a narrow sharp object (a nail, pencil, toothpick)

Some Basics...

  • Punctures are a type of skin wound made by a narrow sharp object.
  • Puncture wounds can become infected, so need proper care.
  • A tetanus shot is often needed after a puncture wound.

Types of Puncture Wounds

  • Needlestick: if the wound is from a used or discarded needle, call a doctor right away. In some cases, medicines need to be started to stop the spread of HIV/AIDS.
  • Foot Punctures: punctures into the bottom of the foot have a 4% risk of infection. This risk is higher in people with puncture wounds that go through a shoe. Pain lasting 4-5 days after the injury may be a sign of infection.
  • Pencil Lead Punctures: pencil lead is made of graphite, which is harmless. Pencils are not made of poisonous lead. Colored lead pencils are also nontoxic. However, the graphite will cause a tattoo if it is not scrubbed out.

When to Call for Puncture Wound

Call 911 Now

  • Deep puncture on the head, neck, chest, back, or stomach
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Severe pain
  • Puncture over a joint
  • Tip of the object is broken off and missing
  • Feels like something is still in the wound
  • Can't stand, put weight on the injury, or walk
  • Needlestick from used needle (may have been exposed to another person's blood)
  • Sharp object was very dirty
  • Setting was dirty and puncture happened to bare foot
  • Dirt in the wound is not gone after 15 minutes of scrubbing
  • Wound looks infected (redness, red streaks, swollen, or tender to touch)
  • Fever
  • You think you have a serious injury
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • You have diabetes and puncture wound of foot
  • Last tetanus shot was more than 5 years ago
  • No past tetanus shots
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Puncture through shoe (athletic shoe) and into bottom of foot
  • Pain not better after 3 days
  • You have other questions or concerns

Self Care at Home

  • Minor puncture wound

Care Advice for Minor Puncture Wound

  1. What You Should Know:
    • Punctures are a type of skin wound made by a narrow sharp object.
    • Puncture wounds can become infected, so need proper care.
    • You can treat minor puncture wounds at home.
    • Here is some care advice that should help.
  2. Cleansing: Wash the wound with soap and warm water for 15 minutes. Scrub the wound with a washcloth to remove any dirt.
  3. Trimming:
    • Gently trim off any flaps of loose skin that cover the wound. These can keep the wound from draining.
    • Use small sharp scissors.
    • Clean the scissors with rubbing alcohol before and after use.
  4. Antibiotic Ointment: Put on an antibiotic ointment covered with an adhesive bandage (Band-Aid) to reduce the risk of infection. Re-soak the area and put on more antibiotic ointment every 12 hours for 2 days.
  5. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  6. Expected Course: Puncture wounds seal over in 1-2 hours. Pain should get better within 2 days.
  7. Call Your Doctor If:
    • Dirt in the wound is still there after 15 minutes of scrubbing
    • It begins to look infected (redness, red streaks, pus, or tender to touch)
    • Fever
    • Pain becomes severe
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.


Last Reviewed: 5/21/2019 1:00:24 AM
Last Updated: 3/14/2019 1:00:27 AM

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