Patient Education

Puncture Wounds

Description

Given the current popularity of vampires and werewolves, (not to mention the ever-present threat from rusty nails, thumbtacks and, of course, very fierce rabbits), it’s probably wise to be fully knowledgeable about all things relating to puncture wounds.

Like other types of cuts, puncture wounds are breaks in the skin that may or may not penetrate to deeper layers (such as muscles and bones). Just as a pesky nail can puncture your tire (probably just as you’re about to drive to an important meeting), so too can sharp, pointed objects (like vampire fangs, for instance) penetrate your skin. The problem is that, unless you have the very good luck of getting stuck by a sterile object, your puncture wound will probably have bits of things that are not good for you stuck inside: dirt, perhaps a piece of your own skin, flakes of rust, saliva (if you were bitten by something), and, of course, germs. (Tetanus is of particular concern.) Sometimes the thing that punched through your skin will, itself, stay embedded in your skin. For instance, a pencil lead might break off, or a needle might be jammed in so deeply that it doesn’t protrude at all above the skin.

Puncture wounds can vary in severity. For instance, if you’ve stepped on a tiny thorn that didn’t penetrate very deeply, the wound probably isn’t too severe. On the other hand, if you impale the ball of your foot on a rusty nail, (or on the teeth of your neighbor’s dog), your wound is going to be more serious. The severity of puncture wounds usually depends on how deeply the object penetrated and how dirty it was when it did so; since dirtier objects contaminate the wound more and deeper punctures can carry contaminants further into your tissues, both increase your risk of developing an infection. (If a vampire bites your foot, it’s really the most serious wound of all.)

Symptoms

Most puncture wounds are accompanied by pain and some bleeding. (Also, if you notice that the area below the wound has some loss of feeling or function, you probably need immediate medical attention.) Bleeding may not last long, and the wound may appear to close very quickly. This doesn’t mean that you’ve completely recovered, though. You may still have bits of stuff that are lurking beneath your skin, just waiting to cause problems. That’s why it’s so important to get yourself and your puncture wound to a podiatrist’s office as soon as you can (preferably within 24 hours of your injury) so he or she can clean and treat it properly.

Those bitten by vampires should probably avoid human contact if possible.

Initial Home Treatment

Before you head to your doctor’s office, there are a few things you can do to clean your wound as much as you can. (This applies even if you’ve been bitten by a vampire. It simply wouldn’t do to have a swollen abscess on your foot for all of your undead life.) If the wound isn’t deep, wasn’t caused by a dirty object, and doesn’t bleed much, you may be able to skip the doctor’s office entirely.

  • First, make sure your hands are clean by washing them with antibacterial soap or hand sanitizer. If your wound is still bleeding, apply pressure (gently!) using a clean cloth. If, after several minutes of pressure, the blood continues to flow or spurt, you need to call 911.
  • Once the bleeding has stopped, rinse your puncture wound thoroughly with water for at least five minutes. (You can even sing a song while you do so to help pass the time. Maybe an aria from La Traviata, if you feel like you can pull it off.)
  • Wash your wound with soap, then check for objects inside the wound by looking, not probing around with tweezers or something. If you find an object, don’t attempt to pull it out yourself; instead, you should get yourself to your friendly local podiatrist.
  • You can apply an antibiotic ointment to help prevent infection, then cover the site with a clean bandage that won’t stick to the wound.

Treatment by Your Podiatrist

If the puncture wound in your foot is deep, caused by a dirty object, or if you notice foreign objects in the wound, you should definitely have it checked out by a foot doctor. (Those with diabetes or others with nerve problems should always see a podiatrist for puncture wound treatment.)

Your podiatrist will examine the wound, checking for embedded objects. The area may be numbed while these objects are retrieved and the wound is thoroughly cleaned. If damage to bones is a possibility, your podiatrist may also get an X-ray of your foot in order to discover the damage and figure out how best to treat it. Your podiatrist may also prescribe antibiotics in order to prevent infection in the wound. You may also be given a tetanus shot, especially if you haven’t had one in the past five years.

Avoiding Infection and Other Complications

Because puncture wounds are prone to infection (which can be quite serious), it’s a good idea to keep an eye on your wound and watch for signs that infection has taken root:

  • Swelling
  • Redness
  • Warmth
  • Pus-like drainage
  • Fever

These symptoms may clear up in a week or two, but if they persist, you should check with your podiatrist for further treatment.

Stay off your foot as much as possible while you recover from your wound. This will give it a chance to heal, and will also help you avoid infection. If your podiatrist has prescribed antibiotics for you, be sure to take the whole prescription, even if you feel fine. Make sure the bandage covering your wound is clean and dry by changing it daily (or more often if it gets wet when someone rudely throws a water balloon at your injured self).

If the wound in your foot was caused by a vampire bite, pretty much the only thing you can do now is hope one of your friends or neighbors has a stake and knows how to use it. Sorry about that.