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November 22, 2009
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Cuts, Scrapes and Puncture Wounds (cont.)

What are the signs of a wound infection?

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.

How are puncture wounds different?

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, however, 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 a 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 or Polysporin) to prevent infection. Cover the wound with a bandage to keep out harmful bacteria and dirt.

Monitor at least daily (ideally three times a day) for signs of infection (the same signs as above in the cuts section). Change the bandage at least daily, or any time it becomes wet or dirty.

Additionally, people with suppressed immune systems or any particularly deep puncture wounds should be seen by a healthcare professional. 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 healthcare professional.

Feet are a particular concern. Wear shoes to minimize the risk of a puncture wound from a nail or glass, especially if you have 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.



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