A puncture wound is caused by a pointed object piercing the skin and creating a small entry hole. This is usually narrower and deeper than a scrape of a cut. Many people can get puncture wounds from household items or work projects, garden tools, or when operating machinery. Puncture wounds usually cause a mild bleeding and pain at the site of the lesion. The puncture wound may go into the tissues below the skin, including fat and muscle. They may be hard to clean and at high risk of becoming infected.

Foreign Bodies in Puncture Wounds

Various foreign bodies can become embedded in a puncture wound. The most common are glass, nails, sewing needles, toothpicks, insulin needles, and seashells. Sometimes, pieces of your socks, shoes, or even your own skin can be forced into the wound as well as dirt and debris. If any of these remain in the wound, this increases the chance of potential problems. It is important to note that all puncture wounds are considered dirty wounds because of penetration of unsterile objects.

Although most puncture wounds are minor and can be managed with home treatment, you must seek medical care immediately if

• It spurts blood
• It bleeds excessively
• Punctures into a joint
• Does not stop bleeding after 5 minutes even with firm pressure
• The puncture wound is deep or touching bone
• The object that caused the puncture cannot be easily removed
• If you suspect that part of the object remains in the wound
• The wound is visibly dirty
• The wound is caused by stepping on a nail or any sharp unclean object
• The wound is caused by a bite
• The wound looks infected
• Fever occurs

Immediate medical attention is important since about 10% of patients will develop soft tissue infection and 2% will develop bone infection. For patients with immune system problems, peripheral neuropathy, peripheral vascular disease, and diabetes, the visible signs of infection may manifest much later. Thus it is important to seek immediate medical treatment. Tetanus immunization history is important, especially in patients with diabetes.

Osteomyelitis or bone infection is the most severe complication secondary to a puncture wound. The outcome will depend on the location of the wound, severity of the injury, delay in treatment, the penetrating object, and the patient’s general medical condition.

There are also a variety of foreign objects that can become embedded in a puncture wound. Some of the most common are nails, glass, needles, and seashells.

If you get a puncture wound, clean it properly. See a foot and ankle surgeon for evaluation and treatment. If possible, do this within 24 hours after the injury.

For more information, you may contact Advanced Wound Healing Institute at (239) 430-3668 (FOOT). Advanced Wound Healing Institute is part of Family Foot and Leg Center, P.A.

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