What is a puncture wound?

Punctures are wounds that go through several layers of skin and may go deeper into the fat, muscle, blood vessels, or other tissues under the skin. A puncture usually enters the skin at one point and is deeper than it is wide. You may not be able to see how deep the wound is.

What is the cause?

Most puncture wounds happen:

• During a fall or an accident
• By stepping on or getting hit with something sharp or pointed
• While working with something sharp, pointed, or jagged (nail guns cause more than 15,000 puncture wounds in the US every year)
• By a deep scratch or bite from an animal

What are the symptoms?

Symptoms may include:

• An opening in the skin, or loss of skin
• Pain
• Redness
• Sometimes bleeding

How is it treated?

The treatment of a wound depends on what caused the wound, where it is, and the size and shape. You can take care of some puncture wounds yourself. A healthcare provider needs to treat large, deep, or dirty wounds. A wound heals more quickly, and with less risk of infection and scarring, when the wound is kept clean and the edges are held close together as it heals.

Call or see your healthcare provider when you have a new puncture wound if:

• You have a large, deep, or jagged wound or bleeding that will not stop.
• You stepped on something that went through your shoe and into your foot.
• You have numbness or tingling near the wound.
• You cannot clean the wound well.
• You cannot see the bottom of the wound.
• You can see fat or muscle in the wound.
• You have not had a tetanus shot in the last 5 years and have a wound caused by a dirty object or there is dirt in the wound.
• You have any questions about how to treat the wound.

How can I take care of myself?

If you have a small puncture wound:

• Wash your hands thoroughly with soap and water for at least 15 seconds before you touch the area.
• Clean the wound as well as possible with mild soap and water. Remove any bits of dirt, small pieces of rock, or other debris that you can easily see, but do not poke or pick at the wound. You may need to soak the wound for 20 minutes, several times a day, for 2 or 3 days to remove all of the debris.
• If it’s bleeding, put pressure on it with a bandage or clean cloth until the bleeding stops, which may take up to 20 minutes.
• Keep the wound and the area around it clean and dry. You may need to put a bandage over the area to keep it clean and dry. Change the bandage every day. Change the bandage more often if it gets dirty or wet.
• To prevent infection in a minor wound, you may use a nonprescription antibiotic ointment. Read the labels and buy products that have only the ingredients that you need and are not allergic to. If you are not sure which medicine is best for your wound, ask your pharmacist.
• Don’t take aspirin if your wound is bleeding. If needed, take nonprescription pain medicine, such as acetaminophen. Acetaminophen may cause liver damage or other problems. Read the label carefully and take as directed. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours or take it for longer than 10 days. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen or naproxen may cause stomach bleeding and other problems. These risks increase with age. Unless recommended by your healthcare provider, don’t take an NSAID for more than 10 days.
• As the wound heals, some swelling, redness, and mild pain are normal.
• Call your healthcare provider if you have:
  • Symptoms of infection, which include new or worse redness, swelling, pain, warmth, or drainage in the area of the wound
  • New bleeding from the wound that won’t stop
  • Pain that is increasing or not getting better with pain medicine
  • Red streaks going from the wound toward the center of your body, for example, up your arm
  • Fever, chills, nausea, vomiting, or muscle aches
  • Any questions about caring for the wound