A
puncture wound is a forceful injury caused by a sharp, pointed object that
penetrates the skin. A puncture wound is usually narrower and deeper than a cut
or scrape. Many people accidentally get puncture wounds with household or work
items, yard tools, or when operating machinery. Most puncture wounds are minor,
and home treatment is usually all that is needed.
Sharp objects,
such as nails, tacks, ice picks, knives, teeth, and needles, can all cause
puncture wounds. Puncture wounds increase your risk of infection because they
are hard to clean and provide a warm, moist place for bacteria to
grow. The bacteria Pseudomonas are a common cause of infections when a puncture wound occurs through the sole of an athletic shoe.
Some punctures are done for
health reasons. For example, a puncture may be used by
a doctor to draw blood or to give fluid or medicines directly into a vein
(intravenous, or IV).
Health professionals
have an increased risk of needle-stick injuries. A puncture from a used needle
increases the risk of infection or for transmitting a blood-borne disease, such
as
hepatitis or
human immunodeficiency virus (HIV). Home treatment may
be all that is needed for puncture wounds from clean needles.
What to do if you get a puncture wound?
When
you have a puncture wound:
Determine if any part of the object that
caused the wound is still in the wound, such as a splinter or
lead (graphite) from a pencil. A pencil
lead puncture wound is less worrisome, so it is not
necessary to check blood levels for lead or worry about lead toxicity or
poisoning.
Determine
if underlying tissues, such as blood vessels, nerves, tendons, ligaments,
bones, joints, or internal organs, have been injured by the
object.
Minor puncture wounds can be
treated effectively at home. If you do not have an increased risk of
infection, you do not have other injuries, and you do not need a tetanus shot or treatment by a
doctor, you can treat a puncture wound at home. Home
treatment can prevent infection and promote healing.
Make sure the object causing the wound is not
still in the wound. Check to see if the object is intact and a piece has not
broken off in the wound.
Try to remove the object that caused the
wound if it is small and you can see it. If you have a splinter, try using
cellophane tape before using clean tweezers or a needle. Simply put the tape
over the splinter, then pull the tape off. The splinter usually sticks to the
tape and is removed painlessly and easily. Be careful, and do not push the
object farther into the wound. Do not wet the splinter.
Stop the bleeding
Allow the wound to bleed freely for up to 5
minutes to clean itself out, unless there has been a lot of blood loss or blood
is squirting out of the wound.
After you have stopped the bleeding, check your
symptoms to determine if and when you need to see your
doctor.
Clean the wound
Clean the wound as soon as possible
to reduce the chance of infection, scarring, and tattooing of the skin from
dirt left in the wound. (If dirt or other debris is not removed from a puncture
wound, the new skin will heal over it. The dirt can then be seen through the
skin and may look like a tattoo.)
Wash the wound for 5 minutes with large
amounts of cool water and soap (mild dishwashing soap, such as Ivory, works
well). Some nonprescription products are available for wound
cleaning that numb the area so cleaning doesn't hurt as much. Be sure to read
the product label for correct use.
Do not use rubbing alcohol,
hydrogen peroxide, iodine, or Mercurochrome, which can harm the tissue and slow
healing.
Consider applying a bandage
Most puncture wounds heal
well and don't need a bandage. You may need to protect the puncture wound from
dirt and irritation. Be sure to clean the wound thoroughly before
bandaging it to reduce the risk of infection occurring under the bandage.
You may have a localized
reaction to a tetanus shot. Symptoms include warmth, swelling, and redness at
the injection site. A fever of up to
100°F (37.8°C) may occur. Home
treatment can help reduce the discomfort.
Pain relief
An ice or cold pack may help reduce
swelling and bruising. Never apply ice directly to a wound or the skin. This
could cause tissue damage.
Elevate the injured area on pillows
while applying ice and anytime you are sitting or lying down. Try to keep the
area at or above the level of your heart to reduce swelling.
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your fever or pain:
Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
Safety tips
Be sure to follow
these safety tips when you use a nonprescription medicine:
Carefully read and follow all
directions on the medicine bottle and box.
Do not take more than
the recommended dose.
Do not take a medicine if you have had an
allergic reaction to it in the past.
If
you have been told to avoid a medicine, call your doctor before you take
it.
If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
To prevent puncture wounds, be sure to practice safety when using blunt or sharp objects.
Pay close attention to what you are
doing.
If you become distracted, set the object aside until you can
pay attention to what you are doing.
Know how to use the object
properly.
Have good lighting so you can see what you are
doing.
Wear gloves whenever possible to protect your
hands.
Wear other safety gear, such as glasses or boots, as
appropriate.
Hold a sharp object away from your body while using
it.
Carry the object with the dangerous end away from
you.
Shut the power off and use safety locks on your power tools
when you are not using them.
Be very careful when using
high-pressure equipment, such as staple guns or paint sprayers. Make sure your
work area is clear of people and hazards that could interfere with the safe
operation of the equipment.
Store dangerous objects in secure
places away from children.
Teach children about safety, and be a
good role model.
Do not use alcohol or drugs when you are handling
sharp objects.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions:
What are your main symptoms? How long have you
had your symptoms?
How and when did the puncture wound occur? Have
you had any injuries in the past to the same area? Do you have any continuing
problems because of the previous injury?
What object caused the
puncture wound? Was there or is there an object in the puncture wound? Was the
object removed in one piece? Did the injury occur under high
pressure?
What home treatment measures have you tried? Did they
help?
What nonprescription medicines have you tried? Did they
help?
What prescription and nonprescription medicine do you
take?
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