Definition

• The skin is punctured by a pointed narrow object (such as a needle)
• Puncture wounds that contain splinters or slivers are covered elsewhere

Health Information

Symptoms

• The main symptom is a little bleeding.
• Puncture wounds are also painful.

Causes

• Commonly caused by a nail, sewing needle, pin, tack, pencil, toothpick.
• Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are not toxic.

Prevention

• Careful adult supervision of young children
• Education of older children about high risk behaviors

Care Advice

1. Overview:
   • Most puncture wounds do not need to be seen.
   • The main risk is becoming infected.
   • Here is some care advice that should help.
2. Cleansing:
   • First wash off the dirty foot or hand with soap and water.
   • Then soak the puncture wound in warm soapy water for 15 minutes.
   • For any dirt or debris, scrub the wound surface back and forth. Use a wash cloth to remove any dirt.
   • If the wound re-bleeds a little, that may help remove germs.
   • Washing the wound right away can prevent infections.
3. Antibiotic Ointment:
   • Use an antibiotic ointment such as Polysporin. No prescription is needed.
   • Then, cover with a Band-Aid to reduce the risk of infection.
   • Re-wash the wound and put on antibiotic ointment every 12 hours.
   • Do this for 2 days.
4. Pain Medicine:
   • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
5. Tetanus Shot:
   • A tetanus shot update may be needed for a puncture wound.
   • Check your vaccine records to see when your child got the last one.
   • If last tetanus shot was given over 5 years ago, your child needs a booster.
   • See your child’s doctor for a booster during regular office hours. It’s safe to give it within 3 days or less.
6. What to Expect:
   • Puncture wounds seal over in 1 to 2 hours.
   • Pain should go away within 2 days.

Call Your Doctor If

• You can’t remove the object that punctured the skin
• Dirt in the wound still there after 15 minutes of scrubbing
• Pain becomes severe
• Looks infected (redness, red streaks, pus, fever)
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

 #AAP