$Unique_ID{PAR00136}
$Pretitle{}
$Title{Medical Advice:  Puncture Wounds}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Puncture Wounds antiseptic head neck abdomen chest joint wound needle
knife blade blades Redness swelling stiffness abrasion abrasions scrape
scrapes laceration lacerations cut cuts nail nails needles pin pins knives
splinters abdominal cavity skull tendon tendons wood glass splinter
Merthiolate red discharge swell swells pain tender tenderness infectious
arthritis knee Punctures Epsom salts soak solution Antibiotics tetanus toxoid
injection injections immunization immunizations}
$Log{}

Your Child:  A Medical Guide


Puncture Wounds


     Quick Reference

     SYMPTOM
     - A wound that is deeper than it is long or wide

     HOME CARE
     - Wash the wound carefully and apply a nonirritating antiseptic.
     - If no foreign body remains in the wound, cover the area with a sterile
       bandage and inspect it regularly for signs of infection.
     - If a foreign body remains in the wound, take the child to the doctor.

     PRECAUTIONS
     - A puncture wound in the head, neck, abdomen, or chest or in a joint
       requires immediate medical attention.
     - Never try to remove a foreign body (for example, a needle or a knife
       blade) from a puncture wound yourself.
     - A puncture wound that is still tender after a day or two should be seen
       by a doctor.
     - Redness, swelling, or stiffness of the joint at the site of a puncture
       wound is a medical emergency.  Take the child to the doctor
       immediately.
     - Make sure that your child's tetanus immunization status is always
       current.


     Wounds that pierce the skin are classified as abrasions (scrapes),
lacerations (cuts), and punctures.  A puncture is a wound that is deeper than
it is long or wide.  Most puncture wounds in children are made by nails,
needles, pins, knives, or splinters.
     Because of their small opening and their depth, puncture wounds are hard
to clean, and therefore are especially susceptible to infection.  A puncture
wound is an ideal site for tetanus to develop because the bacterium that
causes tetanus thrives in the absence of air.  Puncture wounds may also harbor
foreign bodies that are difficult to detect.

SIGNS AND SYMPTOMS

     The presence of a puncture wound usually is obvious.  The important
aspects of the diagnosis involve determining whether the puncture has
penetrated into a deeper structure (such as a joint, the abdominal cavity, the
chest cavity, the skull, or a tendon), whether it contains a foreign body (for
example, a broken needle, a wood or glass splinter, or a shred of clothing),
and whether it is infected.

HOME CARE

     Wash the skin surrounding the puncture with soap and water and apply a
nonirritating, nonstinging antiseptic, such as solution (not tincture) of
Merthiolate antiseptic.  Be sure your child has been immunized against tetanus
within the last five years.  Make sure that the object that made the wound is
intact and has not broken off at the tip.  Inspect and feel the wound to
determine if a foreign body can be detected under the skin.  If no foreign
body is present, cover the wound with a sterile bandage and inspect it twice a
day for signs of infection (redness, discharge, swelling, increasing pain, and
tenderness).  Soak the wound frequently in warm water to help keep it clean.
If there is a foreign body in the wound, take the child to a doctor.

PRECAUTIONS

  -  Puncture wounds in the head, neck, abdomen, or chest can be very serious.
     Take your child to a doctor immediately.
  -  Punctures of a joint may cause infectious arthritis within hours.  The
     knee joint is particularly susceptible.  A puncture near a joint,
     especially the knee, should be seen by a doctor.  Any signs of
     infectious arthritis (redness, swelling, increasing pain, inability to
     move the joint through its full range of normal motion) should be
     considered a medical emergency.
  -  Do not remove an object from a puncture wound--not even if it is a knife
     blade, a nail, a splinter of wood or glass, or a needle.  Let your doctor
     remove it.  You might cause further damage if you try to remove the
     object yourself.
  -  If a puncture wound remains tender for more than one or two days, it
     should be seen by your doctor.

MEDICAL TREATMENT

     A puncture wound cannot be cleaned completely, even by a doctor.  Your
doctor will try to determine if any foreign bodies are present by feeling the
wound or by x-ray examination.  If there is anything in the wound, your doctor
may want it to be removed surgically, or may wait and observe the wound for a
while, perhaps instructing you to soak it in Epsom salts solution for five to
ten minutes four times a day.  Antibiotics will be prescribed if the wound is
infected, and a tetanus toxoid injection will be given if the child's
immunization status is not current.  If a wound has penetrated a joint, the
abdomen, the chest, the skull, or a tendon, your doctor will hospitalize the
child and explore the wound surgically.

RELATED TOPICS:  Arthritis; Cuts; Immunizations; Scrapes; Tetanus