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 (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.

WHEN TO CALL YOUR DOCTOR FOR PUNCTURE WOUND

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 9am and 4pm) 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.

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HOME CARE ADVICE FOR PUNCTURE WOUND

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 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-soak 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 or develops any of the "Call Your Doctor" symptoms.

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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.

Reviewed 8/2004

Revised 7/2002

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