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  • Puncture Wound

    Definition

    • The skin is punctured by a pointed narrow 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 Us for Puncture Wound

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

    • Puncture on the head, neck, chest or stomach that may go deep
    • You think your child has a life-threatening emergency

    Call Us Now (night or day) If:

    • You think your child has a serious injury
    • Bleeding won’t stop after 10 minutes of direct pressure
    • Puncture on the head, neck, chest, or stomach that is not deep
    • Puncture into a joint
    • Tip of the object broke off in the body
    • 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
    • Pain is SEVERE and not improved 2 hours after taking pain medicine
    • Wound looks infected (spreading redness, red streaks)
    • Fever occurs
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

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

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns

    Parent Care at Home If:

    • Minor puncture wound

    Care Advice for Puncture Wound

    What You Should Know:

    • Most puncture wounds do not need to be seen.
    • Here is some care advice that should help.

    Cleansing:

    • 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.

    Trimming:

    • 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.

    Antibiotic Ointment:

    • Use an antibiotic ointment such as Polysporin. No prescription is needed.
    • Then, cover with a Band-Aid to reduce the risk of infection.
    • Re-wash the wound and put on antibiotic ointment every 12 hours.
    • Do this for 2 days.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.

    What to Expect:

    • Puncture wounds seal over in 1 to 2 hours.
    • Pain should go away within 2 days.

    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)
    • Your child becomes worse

    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.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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