Did you know that puncture injuries make up 5% of situations where children go to the emergency room? Puncture wounds occur when a thin, sharp object, such as a nail, tack, or wood splinter, for example, pierces the skin. In most cases, these are very narrow lesions and can be very deep if the object has pierced the skin with force. Smaller perforations can be easily treated at home, without the need to go to the emergency room; on the other hand, serious ones must be treated quickly by medical professionals. Read the following article to learn how to assess and treat puncture wounds – both mild and severe.
Part 1 of 4: Assessing the Injury
Step 1. Take care of the wound immediately
As long as it is treated immediately, injuries caused by sharp objects will not progress to something more serious; otherwise, there may be infection at the site, threatening the patient's life.
Step 2. Calm the patient
This step is very important for children and people who don't handle pain very well. Ask the person to sit or lie down and help them stay calm while giving first aid.
Step 3. Wash your hands with a soap or antibacterial solution
This will prevent infections.
Use alcohol and thoroughly clean all instruments that may be used during treatment. The tweezers must also be properly sanitized
Step 4. Clean the wound with soap and hot water
Remove dirt and debris from the wound by placing it under hot water for five to 15 minutes; then wash the area with soap and a clean cloth.
Step 5. Stop the bleeding
Small perforations usually don't bleed much. With a clean cloth, apply some pressure directly to the pierced area until the bleeding stops.
- A little bleeding may help to clear the cut. It's okay to let small punctures bleed for about five minutes.
- When bleeding continues after several minutes – even when pressure is applied – or if bleeding is heavy, persistent, or causes you concern, seek medical attention immediately.
Step 6. Assess the perforation
Analyze the size and depth of the wound, checking for foreign bodies stuck to the skin. Larger holes may need stitches; when you see one of the following signs, call 911 or go to the emergency room as soon as possible:
- Bleeding doesn't stop after five to ten minutes.
- The wound is 64 cm or more in depth. Even when you manage to stop the bleeding, larger injuries must be treated by professionals.
- A foreign body penetrated deep into the skin. If you cannot see anything but suspect that an object is still present in the perforated location, go to the emergency room.
- The patient stepped on a nail, the injury was caused by a rusty hook or any other kind of rusty object.
- A person or animal has bitten the patient. Bites can cause infections.
- The affected region is numb or the patient cannot move that part of the body normally.
- The wound shows signs of infection, such as redness and swelling around the affected area, increasing pain or feeling that the perforation is throbbing, presence of pus or any other discharge, and even chills or fever (see part 4).
Part 2 of 4: Treating a Serious Puncture Injury
Step 1. Get medical attention immediately
Call SAMU (192) or the medical center of a nearby hospital. When the perforation is severe, only doctors should carry out treatment.
Step 2. Keep pressure on the wound
When bleeding is heavy and there is no access to a clean cloth or bandages, use your hands.
Step 3. Lift the affected body part
Keep the site above the level of the patient's heart if possible as this helps control bleeding.
Step 4. Do not remove objects that get stuck on the skin
Instead, place several clean dressings or cloths around the foreign body, but with little pressure applied to it.
Step 5. Leave the patient in a resting position
To reduce bleeding, the patient must be at complete rest for at least 10 minutes.
Step 6. Monitor the patient
While waiting for the ambulance to arrive, monitor the status of the wound and the person's condition.
- Keep pressure on the wound and replace the dressings if they become full of blood.
- Calm the patient until the paramedics arrive.
Part 3 of 4: Treating a Light Piercing
Step 1. Remove the object (or objects) if it is not large
Small chips, splinters or sharp objects can be removed with disinfected tweezers; if the object is large or is deeply embedded in the flesh, call the SAMU or take the patient to the nearest hospital.
Step 2. Remove dirt and other small particles from the surface of the lesion
Rub the perforated area with a clean cloth and remove chips with disinfected tweezers.
Many types of foreign bodies can be stuck in a puncture wound, including wood, rags, rubber, dirt, and other materials. They may be difficult or even impossible to see when treating the wound at home, but avoid poking at it. If you believe something is still inside the perforation, seek immediate medical attention
Step 3. Treat and bandage the wound
When the piercing is free of dirt and sharp objects, apply an antibacterial ointment or cream and cover with a bandage.
- As smaller perforations are usually not too deep or too extensive, they bleed less and a dressing is not always necessary. However, if the wound is on the foot or other places that get dirty, the dressing can prevent debris from getting into it.
- Topical antibiotics such as Nebacetin are effective and do not need a prescription. Apply them every 12 hours for two days.
- Use porous bandages or bandages that do not stick to the wound. Change them daily so that the site remains dry and healing.
Part 4 of 4: Recovering from a Puncture Injury
Step 1. Carry out the treatment on the affected area with caution
The following steps are recommended for the first 48 to 72 hours after initial care with a light piercing:
- Keep the injured site elevated, above the heart if possible.
- Change dressings if they get dirty or wet.
- Keep the affected area very dry for 24 to 48 hours.
- After 24 to 48 hours, clean the wound with soap and water twice a day. If desired, reapply antibiotic ointments or creams, but avoid alcohol or hydrogen peroxide.
- Avoid activities that might put pressure on the wound by reopening it.
Step 2. Keep an eye out for infections
Small perforations should heal in less than two weeks. If you notice any of the following symptoms, seek immediate medical assistance:
- Pain that increases in intensity and throbbing in the affected area.
- Redness or swelling of the lesion. Especially look for red streaks all around that radiate from the wound.
- Pus or other discharge.
- Unpleasant smell coming out of the lesion.
- Chills or fever from 38°C.
- Swelling in the neck, armpits or groin lymph glands.
Step 3. Take a tetanus shot if necessary
Lesions that come in contact with dirt, dirt or feces can cause a tetanic infection. Use the following guidelines to determine if the patient needs a tetanus booster vaccine and see a doctor for further treatment:
- More than ten years have passed since the patient was last vaccinated against tetanus.
- If the object that pierced the skin was dirty – if you are not sure if it had debris – or if the wound is severe and more than five years have passed since the last tetanus shot.
- The patient is not sure when the vaccine was last given.
- He has never been vaccinated against tetanus.
- Small puncture wounds are generally not serious and do not require specialist medical attention.
- A clean napkin can be used to stop the bleeding, if necessary.