See More Appropriate Topic (instead of this one):

• If NOT, try one of these: Animal or Human Bite
• If NOT, try one of these: Wound Infection
• If NOT, try one of these: Wound Infection
• If NOT, try one of these: Bruise
• If NOT, try one of these: Skin Foreign Body or Object

Is this your child’s symptom

• The skin is punctured by a pointed narrow object

Causes of Puncture Wounds

• Metal: Nail, sewing needle, pin, tack
• Pencil: Pencil lead is actually graphite harmless. It is not poisonous lead. Even colored leads are not toxic.
• Wood: Toothpick

Complications of Puncture Wounds

• Retained Foreign Body Object. This happens if part of the sharp object breaks off in the skin. The pain will not go away until it is removed.
• Wound Infection. This happens in 4% of foot punctures. The main symptom is spreading redness 2 or 3 days after the injury.
• Bone Infection. If the sharp object also hits a bone, the bone can become infected. Punctures of the ball of the foot are at greatest risk. The main symptoms are increased swelling and pain 2 weeks after the injury.

Call 911 Now

• Deep puncture on the head, neck, chest or stomach
• You think your child has a life-threatening emergency

Call Doctor Now or Go to ER

• Puncture into a joint
• Feels like something is still in the wound
• Won’t stand bear weight or walk on punctured foot
• Needle stick from used shot needle
• Sharp object or setting was very dirty such as a playground
• No past tetanus shots
• Dirt in the wound is not gone after 15 minutes of scrubbing
• Severe pain and not improved 2 hours after taking pain medicine
• Wound looks infected spreading redness, red streaks
• Fever occurs
• You think your child has a serious injury
• You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

• Last tetanus shot was over 5 years ago
• You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Minor puncture wound

Care Advice for Puncture Wound

1. What You Should Know About Puncture Wounds:
   • Most puncture wounds do not need to be seen.
   • Here is some care advice that should help.
2. Cleaning the Wound:
   • Wash the wound with soap and warm water for 15 minutes.
   • For any dirt or debris, scrub the wound surface back and forth. Use a wash cloth to remove any dirt.
   • If the wound re-bleeds a little, that may help remove germs.
3. Trim Loose Skin:
   • Cut off any flaps of loose skin that seal the wound. These can interfere with drainage or removing debris.
   • Use a fine scissors. Clean them with rubbing alcohol first.
4. Antibiotic Ointment:
   • Use an antibiotic ointment such as Polysporin. No prescription is needed.
   • Then, cover with a bandage such as Band-Aid. This helps to reduce the risk of infection.
   • Re-wash the wound and put on antibiotic ointment every 12 hours.
   • Do this for 2 days.
5. Pain Medicine:
   • To help with the pain, give an acetaminophen product such as Tylenol.
   • Another choice is an ibuprofen product such as Advil.
   • Use as needed.
6. What to Expect:
   • Puncture wounds seal over in 1 to 2 hours.
   • Pain should go away within 2 days.
7. Call Your Doctor If:
   • Dirt in the wound still there after 15 minutes of scrubbing
   • Pain becomes severe
   • Looks infected redness, red streaks, pus, fever
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Copyright 1994-2015 Barton D. Schmitt, MD. All rights reserved.