What Is A Puncture Wound

Have you ever cut yourself with a knife or glass? The chances are most likely you have, as these are things used in everyday life. Have you ever wondered what may happen if you do not take proper care of the wound and do not sterilize it? These types of wounds are called puncture wounds.

 A puncture wound is a type of wound caused by a sharp object that penetrates the skin and goes deeper into the tissue.

A puncture wound is a very common event that almost everyone has experienced at some point in their life. It can happen anywhere: at the workplace, at home, outside in nature. Not taking proper care of the puncture wound can lead to further complications such as infection. That is why it is important to know what to do and how to treat such types of wounds.

Overview

Puncture wounds are the most common type of wound, as they can be caused by sharp-edged objects. They can vary in severity depending on many factors:¹

• How deep has the object penetrated the skin?
• Is the object dirty (e.g., rusty- nail)?
• How severe is the bleeding? Have you severed a major blood vessel?
• Do you know how to correctly sanitize the wound?
• At what site of the body is the wound located? - e.g., the neck, torso, upper and lower limbs.
• Do you have any bleeding disorders and diseases related to weakened immunity that would affect your healing time? - e.g., Diabetes Mellitus, Haemophilia

Introduction

Definition of puncture wounds

A puncture wound can be described as a wound caused by a sharp object penetrating the skin, such as a nail, knife, needle, bullet, or glass. It is usually narrow but goes deep into the tissue.

Importance of understanding puncture wounds

It is important to correctly assess a puncture wound. Some of them (minor puncture wounds) may be small and non-life threatening, causing only a small tear in the skin and little bleeding. These kinds of puncture wounds can be taken care of at home and do not need a professional medical worker to intervene. Adequate sterilization of the wound and protection against infection is sufficient.

However, there are major puncture wounds that can result in severe internal or external bleeding or both. These kinds of puncture wounds can be life-threatening, especially if the patient has an underlying bleeding disorder and an immune-related disease. Bullet wounds and deep knife cuts can be considered major puncture wounds. Sterilization in most cases would not be enough as surgery may be required.

Common causes of puncture wounds

Most commonly, a puncture wound is the result of household or yard items such as a knife, glass, or garden tools. There are a few types of puncture wounds listed below, categorized by the causative agent of the wound:

• Sharp Objects- e.g.Needles. Nails, Knifes, Glass
• Animal Bites- e.g., Dogs and cats, as these kinds of puncture wounds are prone to infection due to bacterial microorganisms’ presence in the animal's mouth.
• Insect Stings- e.g., bees, wasps, scorpions
• Human bites are bites caused by humans; they also have a high risk of infection.

Risk factors for a slower healing process:

• Age: Older people's skin is thinner and not as elastic; therefore, it is more fragile.
• Underlying health conditions: e.g., Diabetes Mellitus

Signs and symptoms of puncture wounds

Depending on the severity and depth of the wound, there can be little to no bleeding or excessive bleeding, especially if the wound is caused by a sharp object that has obstructed a major blood vessel. That is why it is important in serious cases to not remove the object until a medical professional is present, as it prevents the person from bleeding out. Another factor that can contribute to different symptoms is the rate of infection. For example, if the object is contaminated, this could lead to a serious infection and severe immune reaction (e.g., tetanus).

Complications and risks associated with puncture wounds 

There are complications that can occur upon getting a puncture wound.²

• Infection Risk- Bacteria
• Deep Tissue Damage- depending on the severity and depth of the wound, underlying structures can be damaged such as nerves, tendons, muscles, and blood vessels.
• Foreign Body Retention- foreign bodies may be retained in the wound after puncture of the skin. They would need to be removed for proper healing to take place.
• Tetanus- could be caused if soil dirt or substances containing the tetanus bacteria enter the wound. That is why vaccines are available for such cases.

How to take care of a puncture wound?

There are certain steps that should be taken at home to prevent further infection of the wound.³

• Cleanse the wound- Cleanse the wound with running water and antiseptic solution or soup.
• Stop the bleeding- Apply firm pressure over the wound with a clean cloth or a bandage to stop any bleeding.
• Tetanus check- make sure you have had your tetanus vaccination up to date to avoid a bacterial infection. If out of date, go to the hospital or your GP practice and request a tetanus vaccination.
• Seek Medical Advice- especially if the wound is deep and there is excessive bleeding due to damage of a major blood vessel or if there are any major organs affected. 

Summary

Puncture wounds are mainly caused by sharp objects that puncture the skin. They can be minor and managed at home via correct cleansing and taking care of the wound. However, there are more serious cases that may involve damage to major blood vessels, nerves, tendons, and muscles. Such types of major wounds have to be looked at and taken care of by medical professionals, as the wound has to be assessed correctly to undertake accurate treatment.   For example, vaccination records will be checked, and potential bacterial infections will try to be prevented. Potential sutures can be applied if the wound needs to be closed, and an assessment of potential further complications can be made.

FAQs:

What is a puncture wound?

A puncture wound is an injury that happens when a pointed or sharp instrument pierces the skin and deeper tissues.

What can cause a puncture wound?

Animal bites, insect stings, treading on sharp things like nails or glass, as well as unintentional contact with pointed instruments or objects, can all result in puncture wounds.

How to take care of a puncture wound at home?

• Use mild soap and clean, flowing water to gently clean the wound.
• Apply a topical antibiotic over the counter.
• Put a clean, sterile bandage over the wound.
• Dry out the wound and keep it clean.
• Keep an eye out for infection-related symptoms, including swelling, redness, or increasing pain, and get medical help if any appear.

Do I need a tetanus shot every time I get a puncture wound?

If your immunization is out-of-date, tetanus injections are advised, especially if the wound is big or deep and is infected with dirt or other foreign objects. If you want to know if you need a tetanus booster, talk to your doctor.

What are the possible complications of a puncture wound?

Puncture wounds that are left unattended can develop problems like infection, abscess formation, cellulitis, injury to the muscles, nerves, and blood arteries beneath the skin, and in some cases, systemic infections like sepsis (life-threatening reaction to an infection).