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. First wash off the foot, hand or other punctured skin with soap and water. Then 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.
• Antibiotic ointment. Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Re-soak 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 or standing in dirty water).
• 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.