Puncture wounds are caused by a sharp object, such as a nail, that penetrates skin layers and leaves behind a piercing in the skin. These wounds are prone to infection, as bacteria can be driven deep inside skin, and can be difficult to clean thoroughly. Puncture wounds can be mild or severe, depending on what part of the body is involved, the condition of the nail and depth of the puncture. Tetanus, an infection of the nervous system caused by bacteria, is always a concern with puncture wounds caused by a rusty or dirty nail. Puncture wound treatment should be provided at a medical facility to help prevent infection and wound complications.
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Irrigating, or flushing, a puncture wound helps eliminate any debris or dirt left inside the puncture from the nail. Puncture wounds can introduce bacteria and debris deep into skin tissue; increasing the chance for infection. The National Institutes of Health recommends irrigating a puncture wound with a continuous stream of water for at least five minutes to flush out contaminants. A wash of warm, soapy water can be used after irrigation to further cleanse the puncture. Debris that can be seen and not removed with irrigation may need to be removed under sterile conditions at a medical facility.
Antibiotics may be used to prevent infection from a puncture wound; especially if the nail that caused the wound was dirty or rusty. The Mayo Clinic suggests using topical antibiotic cream on a puncture wound once the wound has been cleansed, to ward off infection. Puncture wounds are often not closed with sutures due to infection risk and must be monitored for signs of infection. Puncture wounds that are slow to heal, become red, swollen or painful to the touch, or leak pus or foul-smelling fluids should be medically treated for infection.
Once a puncture wound has been cleansed, a light dressing can be applied to keep the wound clean and dry and absorb any seepage. Sterile gauze or non-stick pads can be used to cover a puncture wound that can be secured with medical-grade or hypoallergenic tape. Puncture wound dressings are changed daily, or any time it becomes soiled, until the wound has healed.