OHSU

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

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

  1. 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.
  3. 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.
  4. 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.
  5. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for any pain.
  6. Expected Course: Puncture wounds seal over in 1 to 2 hours. Pain should resolve within 2 days.
  7. 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.

 

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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.

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