Puncture Wounds: Care Instructions | Kaiser Permanente

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Overview

A puncture wound can happen anywhere on your body. These wounds tend to be narrower and deeper than cuts.

A puncture wound is usually left open instead of being closed. This is because a puncture wound can be easily infected, and closing it can make infection even more likely.

You will probably have a bandage over the wound.

The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Keep the wound dry for the first 24 to 48 hours. After this, you can shower if your doctor okays it. Pat the wound dry.
• Don’t soak the wound, such as in a bathtub. Your doctor will tell you when it’s safe to get the wound wet.
• If your doctor told you how to care for your wound, follow your doctor’s instructions. If you did not get instructions, follow this general advice:
  • After the first 24 to 48 hours, wash the wound with clean water 2 times a day. Don’t use hydrogen peroxide or alcohol, which can slow healing.
  • You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
  • Apply more petroleum jelly and replace the bandage as needed.
• Prop up the sore area on pillows anytime you sit or lie down during the next 3 days. Try to keep it above the level of your heart. This helps reduce swelling.
• Avoid any activity that could cause your wound to get worse.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

When should you call for help?

Call your doctor now or seek immediate medical care if:

• You have new pain, or your pain gets worse.
• The wound starts to bleed, and blood soaks through the bandage. Oozing small amounts of blood is normal.
• The skin near the wound is cold or pale or changes color.
• You have tingling, weakness, or numbness near the wound.
• You have trouble moving the area near the wound.
• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness around the wound.
  • Red streaks leading from the wound.
  • Pus draining from the wound.
  • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

• The cut reopens.
• You do not get better as expected.

Where can you learn more?

Go to https://www. healthwise.net/patientEd

Enter S876 in the search box to learn more about “Puncture Wounds: Care Instructions”.

Cuts and Puncture Wounds: Causes, Complications, and Prevention

Cuts and Puncture Wounds: Causes, Complications, and Prevention

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Medically reviewed by William Morrison, M. D. — By April Kahn — Updated on November 1, 2019

A cut, or laceration, is a tear or opening in the skin that occurs due to an external injury. It can be superficial, affecting only the surface of your skin or deep enough to involve:

• tendons
• muscles
• ligaments
• bones

A puncture wound is a deep wound that occurs due to something sharp and pointed, such as a nail. The opening on the skin is small, and the puncture wound may not bleed much. Puncture wounds can easily become infected. A doctor should always examine a deep puncture wound. Puncture wounds that occur due to a bite or stepping on a rusty piece of metal, such as a nail, need prompt medical attention.

A cut can cause external and internal bleeding. A significant cut can cause profuse bleeding if it isn’t treated promptly and properly. Cuts and puncture wounds that cause excessive blood loss or those that damage the organs can be fatal.

The most common causes of cuts and puncture wounds are external injuries that break or tear the skin. These causes include:

• falls
• car accidents
• broken glass
• stabbings
• razor cuts

The most common causes for puncture wounds include:

• stepping on a sharp object, such as a nail
• getting bitten
• falling onto something sharp

Although puncture wounds don’t normally bleed heavily, they’re prone to infection. This is especially true if a bite or a rusty object caused the wound. See your doctor immediately if this is the case.

Cuts or puncture wounds that are minor may be treated at home. For more severe cuts or puncture wounds, immediate medical attention is necessary.

Cuts

First, stop any bleeding by covering the cut and applying gentle pressure. If the cut is bleeding heavily and you aren’t able to stop it, seek medical treatment immediately.

Next, clean the cut thoroughly with an alcohol wipe, antiseptic wash, or clean water. Dip a cotton swab into hydrogen peroxide and lightly roll it over the area of the cut to clean it. Use tweezers that have been cleaned with alcohol to remove debris on the surface of the cut. If you see debris embedded in the cut, don’t attempt to remove it. Seek help from your doctor or go to the nearest emergency room.

Once the cut has been cleaned, apply an antibiotic cream to it. This can prevent infection and speed the healing process. Apply a bandage to the cut site. Change the bandage daily and whenever it becomes wet or dirty.

Deeper cuts may require medical treatment. Treatment options for deep cuts include stitches, staples, or liquid stitches.

You may also need to take antibiotics to prevent infection.

Puncture wounds

First, attempt to stop the bleeding by covering the wound with a clean bandage and applying gentle pressure. If the wound is bleeding heavily and you cannot stop it, immediately seek emergency medical care.

Next, clean the area thoroughly using a small alcohol wipe. Don’t attempt to wash a puncture wound. If you notice debris embedded into the puncture wound, don’t try to remove it. Don’t probe the wound if you realize part of the object that caused the wound has broken off. Instead, seek emergency medical attention immediately.

Once the skin is clean, apply an over-the-counter antibiotic cream to prevent infection. Cover the puncture wound with a bandage. You should change the bandage daily or sooner if it becomes wet or dirty. Check for signs of infection, such as:

• redness
• drainage, such as pus, from the wound site
• warmth or swelling in the surrounding area

Although most minor puncture wounds and cuts heal without treatment beyond first aid and home care, some should receive immediate medical attention. Seek emergency medical care if you notice any of the following:

• the bleeding is heavy, spurting, or doesn’t stop after 10 minutes of applying pressure
• feeling and function are impaired in the area of the cut or wound
• muscle, tendon, or bone is exposed

Contact your doctor immediately if:

• debris is embedded in the cut or wound
• the cut or wound occurred due to a bite
• you haven’t had a tetanus shot in 10 years
• you stepped on an object, such as a nail
• the cut or wound occurred due to a fish hook
• the cut or wound shows the symptoms of infection, such as swelling around the site, throbbing pain, or fluid leaking from the cut or wound

Your doctor may suggest you get a tetanus vaccine.

Possible complications from a cut or puncture wound include:

• a wound infection
• a blood infection, or sepsis
• gangrene
• an amputation
• a loss of function in the area of the wound
• nerve damage
• organ damage

Prevent cuts and puncture wounds by taking the following steps to ensure your physical safety:

• Don’t play sports without using proper protective gear.
• Wear shoes and make sure the soles are sturdy and cannot be punctured by a nail.
• Don’t use heavy machinery or tools without wearing proper safety equipment and shoes.
• After an accident, quickly clear away debris, such as broken glass.
• Dry up spills, especially on slippery surfaces, before running or walking over the surface.

Last medically reviewed on October 31, 2019

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Checking out cuts, scratches, and abrasions. (2015, January)
  kidshealth.org/kid/watch/er/cuts.html
• First aid: Cuts, scrapes, and stitches. (2010, December)
  familydoctor.org/familydoctor/en/prevention-wellness/staying-healthy/first-aid/first-aid-cuts-scrapes-and-stitches.html
• Mayo Clinic Staff. (2016, July 23). Cuts and scrapes
  mayoclinic.com/health/first-aid-cuts/FA00042
• Mayo Clinic Staff. (2015, February 4). Puncture wounds: First aid
  mayoclinic.com/health/first-aid-puncture-wounds/FA00014

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Medically reviewed by William Morrison, M.D. — By April Kahn — Updated on November 1, 2019

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Soft tissue wounds – health articles

11/10/2022

What are soft tissue wounds?

Soft tissue injuries include injuries to the skin, mucous membrane, deep-lying tissues (subcutaneous tissue, muscles, etc.), as well as tendons, vessels and nerves. As a result of violation of the integrity of the skin, microbial contamination of the wound surface occurs, which can lead to the development of infection.

According to the damaging factor, wounds are divided into mechanical, thermal (burn) and chemical; on the instrument of injury – on wounds from blunt, sharp objects, tools and weapons, firearms and weapons; according to the nature of the damage, the wounds are classified into bruised, torn, combined, bitten, stab, cut, stab-cut, chopped, sawn, combined bullet, shot, fragmentation.

According to the depth of damage, superficial wounds are distinguished, located in different layers of the skin, and deep, passing in deeper tissues. Wounds of internal organs and joints that communicate with the external environment through a wound channel are called open wounds, and wounds whose wound channels pass through cavities or terminate in them are called penetrating wounds. Wounds of internal organs that do not communicate with the external environment are classified as closed.

Causes

Cut wounds result from the direct impact of a sharp weapon on the surface of the skin.

Chopping wounds are caused by lowering a sharp weapon on the skin at an angle.

Puncture wounds are the result of deep penetration of a sharp thin instrument. Possible injury to the cavities or joints.

Contusion wounds occur when some part of the body comes into contact with a hard obstacle and there is a solid support in the form of the bones of the skull or other bone.

Crushed, crushed wounds are formed due to the impact of a blunt instrument with a wide surface when opposed to a solid support.

Bite wounds. As a result of a bite by an animal or a person, highly virulent causative agents of wound infection can enter the wound.

Symptoms

A closed injury can be suspected by knowing the mechanism of injury (eg, blunt force impact) and by the presence of one or more of the following: bruising, swelling, pain.
Some signs suggest the nature of the injury. For example, swelling and deformity may indicate a closed fracture. A bruise on the head, bloody discharge from the nose, ears and mouth – an injury to the cervical spine or brain is possible. Bruises on the chest, deformation, violation of symmetry – a chest injury is possible with damage to the ribs and sternum. Respiratory failure may indicate lung injury. Large bruises on the abdomen – possible injury to the internal organ.

Signs of a wound vary depending on the type and depth of tissue damage. As a rule, any damage accompanies pain, possibly a violation of the integrity of the skin, as well as bleeding.

Diagnosis

Small, superficial wounds with no general symptoms are diagnosed on clinical grounds. A detailed study is carried out during the primary treatment of the wound. With extensive and deep wounds with a violation of the general condition, additional studies are needed, the list of which is determined taking into account the location of the damage. In case of injuries in the chest area, a chest x-ray is prescribed, in case of damage to the abdomen, an x-ray of the abdominal cavity, ultrasound or laparoscopy, etc. If a violation of the integrity of blood vessels and nerves is suspected, a consultation of a neurosurgeon and a vascular surgeon is required.

Treatment

First medical aid consists of primary surgical treatment of the wound, during which foreign bodies are removed from the wound, bleeding stops, the wound is washed with antiseptics, and non-viable tissues are excised. The issue of prevention of tetanus and rabies (if the wound is bitten) is also being resolved. Wounds with a pronounced inflammatory process are not sutured, they are drained. An infected wound heals by secondary intention. Dressings and drains are changed daily. General treatment consists of anti-inflammatory therapy, the introduction of hemostatic agents, painkillers.

In case of profuse blood loss, the issue of compensating the volume of circulating blood (CBV) is solved, blood substitutes, blood components are introduced. Subsequently, with severe cicatricial contractures and deformities, a restorative operation can be repeated.

Most superficial wounds do not bleed much. Therefore, help consists in bandaging the wound. Before this procedure, the edges are smeared with an antiseptic, making sure that it does not get into the wound.

The wound is covered with a sterile dressing and bandaged. If the edges of the wound are strongly dispersed, before applying the bandages, they must be brought together (but not until they close) and fixed in this position with 2-3 strips of adhesive tape.

The wound must not be washed with water (risk of infection), nor with alcohol or tincture of iodine. The disinfectant solution, getting into the wound, causes the death of damaged cells, and also causes significant pain. No ointment should be applied to the wound, and cotton should not be placed directly into the wound.

Vitamin therapy should not be forgotten. Vitamin deficiency sharply slows down reparative (restorative) processes.

To accelerate wound healing, proper nutrition of patients is important, especially those who have undergone traumatic shock, severe infection or major surgery. They need a complete diet with an increased amount of protein and vitamins. Physiotherapy exercises are indicated primarily for purulent wounds of the upper extremities.