Puncture Wounds
Puncture wounds are common and may be caused by a variety of sharp objects such as nails, plant material, fishhooks, knives, needles, or animal bites. Puncture wounds are superficial skin wounds, not to be confused with the deeper, and potentially, more serious stab wound. These minor wounds are still important, due to the possibility of retained foreign material and increased risk of infection. Puncture wounds are generally not sutured, but may be surgically explored by the physician, using a local anesthetic. Treatment includes a thorough initial cleansing, with subsequent soapy soaks (dilute betadine or mild dish soap) for 20 to 30 minutes, several times a day [for a few days]. This will serve to passively remove debris and reduce the risk of infection. Apply a clean gauze dressing if the wound is in an area of potential contamination (the feet being a good example). Tetanus vaccination should be within the last 5 years. Prophylactic antibiotics will be indicated in some cases which involve retained foreign material, foot puncture, cat bite, or puncture wound in a diabetic patient. Bone x-rays will be useful if a glass or metal foreign object (needle) is suspected. Watch closely for SIGNS OF INFECTION: increasing pain at the site, increasing swelling, redness, red streaks, discharge from the wound, or fever. Close medical follow-up is necessary for 24 to 48 hours after injury.
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