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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Cuts, scrapes (abrasions), and puncture wounds facts
• What is the best way to care for a cut or scrape?
• Who should seek medical care for a cut?
• What are the signs and symptoms of a wound infection?
• How are puncture wounds different?
• Will I need a tetanus shot for a cut, scrape, or puncture wound?
• Cuts, Scrapes and Puncture Wounds Index

If the wound begins to drain yellow or greenish fluid (pus), or if the skin around the wound becomes red, warm, swollen, or increasingly painful; a wound infection may be present and medical care should be sought. Any red streaking of the skin around the wound may indicate an infection in the system that drains fluid from the tissues, called the lymph system. This infection (lymphangitis) can be serious, especially if it is accompanied by a fever. Prompt medical care should be sought if streaking redness from a wound is noticed.

A puncture wound is caused by an object piercing the skin, creating a small hole. Some punctures can be very deep, depending on the source and cause.

Puncture wounds do not usually bleed much, but, treatment is necessary to prevent infection. A puncture wound can cause infection because it forces bacteria and debris deep into the tissue, and the wound closes quickly forming an ideal place for bacteria to grow.

For example, if a nail penetrates deep into the foot, it can hit a bone and introduce bacteria into the bone. This risk is especially great if an object has gone through a pair of sneakers. The foam in sneakers can harbor bacteria (Pseudomonas) that can lead to serious infection in the tissues.

First aid for puncture wounds includes cleaning the area thoroughly with soap and water. These wounds are very difficult to clean out. If the area is swollen, ice can be applied and the area punctured should be elevated. Apply antibiotic ointments (Bacitracin, Polysporin, Neosporin) to prevent infection. Cover the wound with a bandage to keep out harmful bacteria and dirt. Cleanse the puncture wound and change the bandage three times a day, and monitor for signs of infection (the same signs as above in the cuts section). Change the bandage any time it becomes wet or dirty.

People with suppressed immune systems or any particularly deep puncture wounds should be seen by a health care practitioner. If it is difficult to remove the puncturing object, it may have penetrated the bone and requires medical care.

Most puncture wounds do not become infected, but if redness, swelling or bleeding persists, see your health care practitioner.

Puncture wounds to the feet are a particular concern. Wear shoes to minimize the risk of a puncture wound from a nail or glass, especially if the affected person has diabetes or loss of sensation in the feet for any reason.

Additional common causes of puncture wounds can include animal or human bites, or splinters from wood or other plant material, which carry a high risk of infection and should be treated by a physician.