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Puncture Wounds

What is a puncture wound?

A puncture wound is when the skin has been completely punctured by an object that is pointed and narrow, such as a nail. The wound is not wide enough to need stitches.

Because puncture wounds usually seal over quickly, there is a greater chance of wound infection with this type of skin injury. Puncture wounds of the upper eyelid are especially dangerous because they may puncture the brain and lead to a brain abscess. A deep infection of the foot can begin with swelling of the top of the foot 1 to 2 weeks after the puncture. Another risk is tetanus if your child is not immunized against tetanus.

How can I take care of my child?

  • Cleansing. Soak the wound in warm water and soap for 15 minutes. Scrub the wound with a washcloth to remove any debris. If the wound rebleeds a little, that may help remove germs.
  • Trimming. Cut off any flaps of loose skin that cover the wound and interfere with drainage or removing debris. Use fine scissors after cleaning the scissors with rubbing alcohol.
  • Antibiotic ointment. Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Resoak the area and reapply antibiotic ointment every 12 hours for 2 days.
  • Pain relief. Give acetaminophen (Tylenol) or ibuprofen (Advil) for any pain.

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

  • Puncture of the face, neck, chest or abdomen.
  • Dirt in the wound remains after you have soaked the wound.
  • The tip of the object could have broken off in the wound.
  • The wound is very deep.
  • The sharp object or place where the injury occurred was very dirty (for example, a barnyard).
  • The wound looks infected (redness, streaks, pus).

Call during office hours if:

  • It has been at least 5 years since your child last had a tetanus booster.
  • Pain, redness, or swelling increases after 48 hours.
  • You have other questions or concerns.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2009-08-13
Last reviewed: 2012-05-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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