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Puncture Wound


Puncture Wound - With a Foreign Body


Puncture Wound - BB Gun


X-Ray - BB in Left Upper Arm


First Aid - Wound - How to Clean


First Aid - Removing a Splinter

Definition

  • The skin is punctured by a narrow, pointed object

Causes

  • Commonly caused by a nail, sewing needle, pencil, toothpick
  • Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are not toxic.

When to call your doctor

Call 911 Now (your child may need an ambulance) If

  • Puncture on the head, neck, chest or abdomen that may go deep

Call Your Doctor Now (night or day) If

  • You think your child has a serious injury
  • Bleeding that won't stop after 10 minutes of direct pressure
  • 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 still in the wound
  • Won't stand (bear weight or walk) on punctured foot
  • Needle stick from used or discarded injection needle
  • Sharp object or setting was very dirty (e.g., a barnyard)
  • No previous tetanus shots
  • Dirt (debris) or pencil lead pigment is not gone after 15 minutes of scrubbing
  • Severe pain
  • Wound looks infected (redness, red streaks, swollen, tenderness)
  • Fever occurs
  • You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently
  • Last tetanus shot over 5 years ago

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Parent Care at Home If

  • Minor puncture wound and you don't think your child needs to be seen

HOME CARE ADVICE FOR PUNCTURE WOUND

  1. Cleansing:
    • Wash the wound with soap and warm water for 15 minutes.
    • For any dirt or debris, scrub the wound surface back and forth with a wash cloth to remove it.
    • If the wound re-bleeds a little, that may help remove germs.
  2. 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.
  3. Antibiotic Ointment: Apply an antibiotic ointment such as Polysporin (no prescription needed). Then, cover with a Band-Aid to reduce the risk of infection. Re-wash the area and re-apply an antibiotic ointment every 12 hours for 2 days.
  4. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for any pain.
  5. Expected Course: Puncture wounds seal over in 1 to 2 hours. Pain should resolve within 2 days.
  6. Call Your Doctor If:
    • Dirt in the wound persists after 15 minutes of scrubbing
    • Pain becomes severe
    • It begins to look infected (redness, red streaks, tenderness, pus, fever)
    • Your child becomes worse
Author: Barton D. Schmitt, M.D.
Last reviewed: 9/15/2011
Last revised: 8/1/2011 3:15:53 PM

Copyright 1994-2012 Barton D. Schmitt, M.D.