- Skin is
punctured by a narrow sharp object (e.g., a nail, pencil, toothpick).
Any needlestick from a used or discarded needle should be reported immediately
to the doctor. In some cases, medicines should be started to prevent
transmission of the HIV (AIDS) virus.
Foot Punctures through Athletic Shoes: Puncture wounds into
the bottom of the foot have a risk of infection of approximately 4%. This increases
to 25% in patients with puncture wounds through athletic (tennis) shoes into
the bottom of the foot near the toes. Pain persisting greater than 4-5 days
after the injury is suggestive of infection.
Pencil Lead Punctures: Pencil lead is actually graphite (harmless),
not poisonous lead. Even colored leads are nontoxic. They will cause a tattoo,
however, and should be scrubbed out.
See More Appropriate Topic (instead of this one) If
WHEN TO CALL YOUR DOCTOR FOR
Call 911 Now (you may need an ambulance) If:
on the head, neck, chest, back, or abdomen that may go deep
Call Your Doctor Now (night or day) If:
- You think
you have a serious injury
- Severe pain
- 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 is still in the wound
- Can'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 barnyard)
- Setting was dirty and puncture occurred 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
- 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
you need to be seen
- Diabetic and puncture wound of foot
- Last tetanus booster was over 5 years ago
Call Your Doctor During Weekday Office Hours If:
- You have
other questions or concerns
- Pain has not improved after
Self Care at Home If:
- Minor puncture
wound and you don't think you need to be seen
HOME CARE ADVICE FOR MINOR
- Cleansing: Wash
the wound with soap and warm water for 15 minutes. For any dirt or debris, scrub
the wound back and forth with a washcloth to remove it.
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-soak the area and re-apply an antibiotic ointment
every 12 hours for 2 days.
Pain Medication: For pain relief, take acetaminophen every 4-6 hours
(e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil,
Motrin; adult dosage 400 mg).
- Do not take ibuprofen if you have stomach problems, kidney disease,
are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory
drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications
that you take.
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
- It begins to look infected (redness, red streaks, tenderness,
- Pain becomes severe
- You become worse or develop any of the "Call Your Doctor"
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.
Adult HouseCalls Online. Copyright © 2000-2004
David Thompson, M.D. FACEP
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