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Cuts and puncture wounds

Definition

A cut is a break or opening in the skin. It is also called a laceration. A cut may be deep, smooth, or jagged. It may be near the surface of the skin, or deeper. A deep cut can affect tendons, muscles, ligaments, nerves, blood vessels, or bone.

A puncture is a wound made by a pointed object such as a nail, knife, or sharp tooth.

Figures

Alternative Names

Wound - cut or puncture; Open wound; Laceration; Puncture wound

Symptoms

Bleeding
Problems with function or feeling below the wound site
Pain

Infection may occur with some cuts and puncture wounds. The following are more likely to become infected:

Bites
Punctures
Crushing injuries
Dirty wounds
Wounds on the feet
Wounds that are not promptly treated

First Aid

If the wound is bleeding severely, call your local emergency number such as 911.

Minor cuts and puncture wounds can be treated at home. Take the following steps.

FOR MINOR CUTS

Wash your hands with soap or antibacterial cleanser to prevent infection.
Then, wash the cut thoroughly with mild soap and water.
Use direct pressure to stop the bleeding.
Apply antibacterial ointment and a clean bandage that will not stick to the wound.

FOR MINOR PUNCTURES

Wash your hands with soap or antibacterial cleanser to prevent infection.
Rinse the puncture for 5 minutes under running water. Then wash with soap.
Look (but do not poke around) for objects inside the wound. If found, do not remove it. Go to your emergency or urgent care center.
If you cannot see anything inside the wound, but a piece of the object that caused the injury is missing, also seek medical attention.
Apply antibacterial ointment and a clean bandage that will not stick to the wound.

Do Not

Do NOT assume that a minor wound is clean because you can't see dirt or debris inside. Always wash it.
Do NOT breathe on an open wound.
Do NOT try to clean a major wound, especially after the bleeding is under control.
Do NOT remove a long or deeply stuck object. Seek medical attention.
Do NOT push or pick debris from a wound. Seek medical attention.
Do NOT push body parts back in. Cover them with clean material until medical help arrives.

Call immediately for emergency medical assistance if

Call 911or your local emergency number if:

The bleeding is severe or cannot be stopped (for example, after 10 minutes of pressure).
The person can not feel the injured area, or it doesn't work right.
The person is seriously injured.

Call your doctor immediately if:

The wound is large or deep, even if the bleeding is not severe.
The wound is more than a quarter inch deep, on the face, or reaching the bone. Stitches may be needed.
The person has been bitten by a human or animal.
A cut or puncture is caused by a fishhook or rusty object.
You step on a nail or other similar object.
An object or debris is stuck. Do not remove it yourself.
The wound shows signs of infection such as warmth and redness in the area, a painful or throbbing sensation, fever, swelling, or pus-like drainage.
You have not had a tetanus shot within the last 10 years.

If you have a serious wound, your doctor may order blood tests to check for bacteria.

Prevention

Keep knives, scissors, firearms, and fragile items out of the reach of children. When children are old enough, teach them to how to use knives and scissors safely.

Make sure you and your child are up to date on vaccinations. A tetanus vaccine is generally recommended every 10 years.

References

Lammers RL. Principles of Wound Management. In: Roberts IR, Hedges JR eds. Roberts: Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa. Saunders Elsevier; 2009: chap 39.

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