Illness & Symptoms
Puncture Wound
Is this your child's symptom?
- The skin is punctured by a pointed narrow object
 
- If NOT, try one of these: 
 - Human or Animal Bite
 - Skin Injury
 - Sliver or Splinter
 - Wound Infection
 
Causes of Puncture Wounds
- Metal: nail, sewing needle, pin, tack
 - Pencil: pencil lead is actually graphite (harmless). It is not poisonous lead. Even colored leads are not toxic.
 - Wood: toothpick
 
Complications of Puncture Wounds
- Retained Foreign Object. This happens if part of the sharp object breaks off in the skin. The pain will not go away until it is removed.
 - Wound Infection. This happens in 4% of foot punctures. The main symptom is spreading redness 2 or 3 days after the injury.
 - Bone Infection. If the sharp object also hits a bone, the bone can become infected. Punctures of the ball of the foot are at greatest risk. The main symptoms are increased swelling and pain 2 weeks after the injury.
 
When to Call for Puncture Wound
 Call 911 Now
 Call Doctor or Seek Care Now
  |  
  Contact Doctor Within 24 Hours
 Contact Doctor During Office Hours
  |  
  Self Care at Home
  |  
Call 911 Now
- Deep puncture on the head, neck, chest, back or stomach
 - You think your child has a life-threatening emergency
 
Call Doctor or Seek Care Now
- Puncture into a joint
 - Feels like something is still in the wound
 - Won't stand (bear weight or walk) on punctured foot
 - Needlestick from used needle (may have been exposed to another person's blood)
 - Sharp object or setting was very dirty (such as a playground or dirty water)
 - No past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
 - Dirt in the wound is not gone after 15 minutes of scrubbing
 - Severe pain and not better 2 hours after taking pain medicine
 - Wound looks infected (spreading redness, red streaks)
 - Fever
 - You think your child has a serious injury
 - You think your child needs to be seen, and the problem is urgent
 
Contact Doctor Within 24 Hours
- Last tetanus shot was more than 5 years ago
 - You think your child needs to be seen, but the problem is not urgent
 
Contact Doctor During Office Hours
- You have other questions or concerns
 
Self Care at Home
- Minor puncture wound
 
Care Advice for Puncture Wound
What You Should Know About Puncture Wounds:
- Most puncture wounds do not need to be seen.
 - Here is some care advice that should help.
 
Cleaning the Wound:
- First wash off the foot, hand or other punctured skin with soap and water.
 - Then soak the puncture wound in warm soapy water for 15 minutes.
 - For any dirt or debris, gently scrub the wound surface back and forth. Use a wash cloth to remove any dirt.
 - If the wound re-bleeds a little, that may help remove germs.
 
Antibiotic Ointment:
- Use an antibiotic ointment (such as Polysporin). No prescription is needed.
 - Then, cover with a bandage. This helps to reduce the risk of infection.
 - Re-wash the wound and put on antibiotic ointment every 12 hours.
 - Do this for 2 days.
 
Pain Medicine:
- To help with the pain, give an acetaminophen product (such as Tylenol).
 - Another choice is an ibuprofen product (such as Advil).
 - Use as needed.
 
What to Expect:
- Puncture wounds seal over in 1 to 2 hours.
 - Pain should go away within 2 days.
 
Call Your Doctor If:
- Dirt in the wound still there after 15 minutes of scrubbing
 - Pain becomes severe
 - Looks infected (redness, red streaks, pus, fever)
 - You think your child needs to be seen
 - Your child becomes worse
 
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2025 Schmitt Pediatric Guidelines LLC.
Reviewed: 5/1/2025 Updated: 1/25/2025

