Puncture Wound

Injury Definition

• The skin is punctured by a narrow, sharp object (e.g. a nail, pencil, toothpick)
• Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are not toxic. They will cause a tattoo, however, and should be scrubbed out

See More Appropriate Topic

• If animal caused it, see Animal or Human Bites
• If looks infected, see Wound Infection
• If skin is cut or scraped (not punctured), see Skin Trauma

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

• Puncture on the head, neck, chest or abdomen that may be 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
• Won’t stand (bear weight or walk) on punctured foot
• Needle stick from used or discarded injection needle
• Sharp object was very dirty (e.g. a rusty nail)
• Setting was dirty and occurs on bare foot
• No previous tetanus shots
• Dirt (debris) or pencil lead pigment that can be seen in the wound 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 and 4) If

• You think your child needs to be seen
• Last tetanus booster was 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 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 rebleeds a little, that may help remove germs.
2. 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.
3. Antibiotic Ointment: Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Re-soak the area and re-apply an antibiotic ointment every 12 hours for 2 days.
4. Pain Medicine: Give acetaminophen or ibuprofen for any pain.
5. Expected Course: Puncture wounds seal over in 1 to 2 hours. Pain should resolve within 2 days.
6. 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 or develops any of the “Call Your Doctor Now” symptoms