Puncture Wound
What is a puncture wound?
A puncture wound is a hole in the skin made by a sharp, pointed object. The wound may just be on the surface of the skin or it can be very deep. In some cases, a puncture wound may be more serious than what it looks like. Blood vessels, nerves, bones, and other tissues under the skin may be damaged. The wound may become infected when germs get into it. Infection often occurs when the object that caused the wound carries germs or pushes dirt into the tissues.
What causes a puncture wound?
A puncture wound may be caused by a nail, needle, wood, glass, plastic, or metal. It may also be caused by sharp teeth, such as a cat bite. Stepping on a pointed object is a common cause of puncture wounds.
What are the signs and symptoms of a puncture wound?
You may see a small hole in your skin. The area may be bruised or swollen. You may have bleeding, pain, or trouble moving the affected area. If the wound becomes infected, it may have pus in it. The area around the pus may be red and feel warm when touched. You may also develop a fever.
How is a puncture wound diagnosed?
History:
Your caregiver will need to know when and how you were wounded. He also needs to know if you have other health problems, are taking medicines, and had past surgeries. Knowing what vaccinations (shots) you have received, such as tetanus, is also important.
Physical exam:
Your caregiver will look closely at your injury, including the area around it. He will check to see how deep the wound is. He will also look for other problems or signs of infection. How well you move and feel things in your injured body part may be tested.
Tests:
Different tests may be done to check for other problems that may come with your puncture wound.
Blood tests:
You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
Imaging tests:
Pictures of your bones and tissues in the wound area may be taken using different imaging tests. Tests may include x-rays, computed tomography (CT) scan, magnetic resonance imaging (MRI), ultrasound, or a bone scan. Caregivers can use the pictures to check whether a foreign object was left in the wound area.
How is a puncture wound treated?
Treatment will depend on how severe the wound is, its location, and whether other areas are affected. It may also depend on your health and the length of time you have had the wound. You may need any of the following treatments:
Wound cleaning:
Soap and water are used to wash away germs and decrease the chance of infection. Your caregiver may cut open a part of the affected area to be able to clean it better. The wound may be rinsed with sterile (clean) water under pressure, using a needle or catheter (tube) tip and large syringe. Germ-killing solutions may also be used. Objects, dirt, or dead tissues from the wound will be removed with debridement (surgical cleaning). Your caregiver may also drain the wound to clean out pus.
Medicines:
Antibiotics may be given to fight or stop infection. You may be given medicine to decrease pain, swelling, and fever. A tetanus shot and immune globulins may also be given. Ask your caregiver for more information about these medicines.
Surgery:
You may need surgery if your wound is deep and blood vessels, bones, or nerves need to be repaired. Your wound may be left open until it heals or may be closed right away using stitches (threads).
Others:
Rest and keep the wound raised above your heart. This will help decrease swelling. Crutches may be used for 2 to 3 days if the puncture wound is in the foot. These may help you walk with ease and protect your foot from further injury.
Where can I find more information?
Contact the following for more information about puncture wounds:
American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
913-906-6000
1-800-274-2237
http://www.aafp.org
