- The skin is punctured by a narrow, pointed object
- 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 FOREIGN BODY IN SKIN
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
- Bleeding that won't stop after 10 minutes of direct pressure
- 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
- You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen, but not urgently
- 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
- 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
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: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.