Don't Mess With Puncture Wounds!

Don't Mess With Puncture Wounds!
I stepped on something and it stuck in my foot. No big
deal, I pulled it out and cleaned the area. Now my foot is
red, hot and swollen....what should I do? This scenario
happens every day and the swollen, infected part could have
been easily avoided with a quick trip to the podiatrist.
Puncture wounds are extremely common in the foot,
especially in times of warm weather, due to people walking
barefoot. Even though they are extremely common, most
people do not treat them adequately. Getting proper
treatment within 24 hours is important in decreasing the
infections that lead to serious complications.

Proper treatment should start with prevention! Do not go
barefoot, especially outside and in the garage where loose
objects and foot terrors seem to lurk! Keep knives,
scissors, and breakables out of the reach of children.
Remove nails from boards and dispose of them properly.
Always sweep up glass immediately after breaking an object.
Keep areas free from trash and debris. Keep up to date on
your tetanus vaccination (every 10 years is recommended).

Foreign objects embedded in a puncture wound are extremely
common. All kinds of things like toothpicks, glass, small
pebbles, needles, nails and even wiry pet hair can become
stuck in a puncture wound. Even pieces of your own skin,
sock and shoe as well as dirt and foliage can be
contaminating a puncture wound. Remember that all puncture
wounds are considered dirty wounds because they involve
penetration of the skin with a dirty object. Don't assume
that a minor wound is clean just because you can't see dirt
in it. Don't even try to clean or take large objects out of
a serious wound. Go to the ER immediately if you have a
large wound, an embedded deep object or the bleeding
doesn't stop after 5 minutes! Regardless of the foreign
body, anything that remains in a wound can become an
abscess and lead to a severe infection.

Treatment of puncture wounds should begin within 24 hours
of the wound and start with cleansing of the wound and
close monitoring until it is healed. Surgical cleaning with
removal of any foreign bodies is often necessary coupled
with a week or two of antibiotics, depending on the wound
contamination. A recent study recommended that all puncture
wounds in the foot should be treated with at least 1 week
of oral antibiotics. X-rays may even be needed to evaluate
the bone for any involvement. A bonus is that metallic
foreign bodies can also be detected by x-ray.

Often foreign bodies can be missed in the emergency room,
so proper follow up with your podiatrist is important.
Infection is a common complication, so your doctor will
monitor your wound closely until it heals. Any changes,
swelling, redness or discharge should be reported
immediately. In diabetics or patients with poor
circulation, a puncture wound can lead to an infection so
serious that it leads to an amputation.

Do not delay treatment! Hindsight is always 20/20, but you
don't want to be the one wishing they had come into the
office when they are in the hospital with a severe
infection. Do not play around with puncture wounds, seek
medical attention immediately!

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For more information on foot and ankle health, visit our
website at http://www.faant.com or my blog at
http://www.myrundoc.com . For a podiatrist in your area,
visit the American College of Foot and Ankle Surgeons
consumer website at http://www.footphysicians.com .