Print this page Email this page

Puncture Wound

DEFINITION

The skin is punctured by a narrow, pointed 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.

See More Appropriate Topic (instead of this one) If

Animal caused it, see ANIMAL OR HUMAN BITE
Looks infected, see WOUND INFECTION
Skin is cut or scraped (not punctured), see SKIN INJURY
Foreign body (e.g., sliver) remains in the skin, see SKIN FOREIGN BODY

WHEN TO CALL YOUR DOCTOR

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

Puncture on the head, neck, chest or abdomen that may go deep

Call Your Doctor Now (night or day) If

You think your child has a serious injury
Puncture on the head, neck, chest, abdomen that isn't deep
Puncture overlying a joint
Tip of the object is broken off and missing
Feels like something still in the wound
Won't stand (bear weight or walk) on punctured foot
Needle stick from used or discarded injection needle
Sharp object or setting was very dirty (e.g., a barnyard)
No previous tetanus shots
Dirt (debris) or pencil lead pigment is not gone after 15 minutes of scrubbing
Severe pain
Wound looks infected (redness, red streaks, swollen, tenderness)
Fever occurs

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

You think your child needs to be seen
Last tetanus shot over 5 years ago

Call Your Doctor During Weekday Office Hours If

You have other questions or concerns

Parent Care at Home If

Minor puncture wound and you don't think your child needs to be seen

HOME CARE ADVICE FOR PUNCTURE WOUND

Cleansing:
- Wash the wound with soap and warm water for 15 minutes.
- For any dirt or debris, scrub the wound surface back and forth with a wash cloth to remove it.
- If the wound re-bleeds a little, that may help remove germs.
Trimming: Cut off any flaps of loose skin that seal the wound and interfere with drainage or removing debris. Use a fine scissors, after cleaning them with rubbing alcohol.
Antibiotic Ointment: Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Re-wash the area and re-apply an antibiotic ointment every 12 hours for 2 days.
Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for any pain.
Expected Course: Puncture wounds seal over in 1 to 2 hours. Pain should resolve within 2 days.
Call Your Doctor If:
- Dirt in the wound persists after 15 minutes of scrubbing
- Pain becomes severe
- It begins to look infected (redness, red streaks, tenderness, pus, fever)
- Your child becomes worse

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

Back to top | Return to Full List of Topics

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.
Last Reviewed: 3/15/2008
Last Revised: 6/24/2008
Content Set: Pediatric HouseCalls Online
Copyright 1994-2008 Barton D. Schmitt, M.D.