Index 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 because they may puncture the brain and 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.
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:
- Puncture of the face, neck, chest or abdomen.
- 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 Barton D. Schmitt, MD, author of “My Child Is Sick”, American Academy of Pediatrics Books. Published by RelayHealth.
Last modified: 2009-08-13
Last reviewed: 2011-06-06 This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Pediatric Advisor 2011.4 Index
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