Puncture Wound
- Skin is punctured by a narrow sharp object (e.g., a nail, pencil, toothpick).
General Information
- Needlesticks: Any needlestick from a used or discarded needle should be reported immediately to the doctor. In some cases, medicines should be started to prevent transmission of the HIV (AIDS) virus.
- Foot Punctures through Athletic Shoes: Puncture wounds into the bottom of the foot have a risk of infection of approximately 4%. This increases to 25% in patients with puncture wounds through athletic (tennis) shoes into the bottom of the foot near the toes. Pain persisting greater than 4-5 days after the injury is suggestive of infection.
- Pencil Lead Punctures: Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are nontoxic. However, they will cause a tattoo and should be scrubbed out.
See More Appropriate Topic (instead of this one) If
WHEN TO CALL YOUR DOCTOR
Call 911 Now (you may need an ambulance) If
- Puncture on the head, neck, chest, back, or abdomen that may go deep
Call Your Doctor Now (night or day) If
- You think you have a serious injury
- Severe pain
- Puncture on the head, neck, chest, abdomen that isn't deep
- Puncture overlying a joint
- Tip of the object is broken off and missing
- Feels like something is still in the wound
- Can't stand (bear weight or walk) on punctured foot
- Needle stick from used injection needle, and you were possibly exposed to another person's blood
- Sharp object was very dirty (e.g. a barnyard)
- Setting was dirty and puncture occurred on bare foot
- No previous tetanus shots
- Dirt (debris) that can be seen in the wound is not gone after 15 minutes of scrubbing
- Wound looks infected (redness, red streaks, swollen, tenderness)
- Fever occurs
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If:
- You think you need to be seen
- Diabetic and puncture wound of foot
- Last tetanus booster was over 5 years ago
Call Your Doctor During Weekday Office Hours If
Self Care at Home If
- Minor puncture wound and you don't think you need to be seen
HOME CARE ADVICE FOR MINOR PUNCTURE WOUND
- Cleansing: Wash the wound with soap and warm water for 15 minutes. For any dirt or debris, scrub the wound back and forth with a washcloth to remove it.
- Trimming: Cut off any flaps of loose skin that seal the wound and interfere with drainage or removing debris. Use a fine scissors, after cleaning them with rubbing alcohol.
- Antibiotic Ointment: Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Re-soak the area and re-apply an antibiotic ointment every 12 hours for 2 days.
- Pain Medication:
- For pain relief, take acetaminophen or ibuprofen
- Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
- Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
- People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
- CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- CAUTION: Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications that you take.
- Expected Course: Puncture wounds seal over in 1 to 2 hours. Pain should resolve within 2 days.
- Call Your Doctor If:
- Dirt in the wound persists after 15 minutes of scrubbing
- It begins to look infected (redness, red streaks, tenderness, pus, fever)
- Pain becomes severe
- You become worse
And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.
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