Puncture wounds are not the same as cuts. A puncture wound has a small entry hole caused by a pointed object, such as a nail that you've stepped on. In contrast, a cut is an open wound that produces a long tear in the skin. Puncture wounds require different treatment from cuts because these small holes in the skin can disguise serious injury.
Puncture wounds are common in the foot, especially in warm weather when people go barefoot. But even though they occur frequently, puncture wounds of the foot are often inadequately treated. If not properly treated, infection or other complications can develop.
Proper treatment within the first 24 hours is especially important with puncture wounds because they carry the danger of embedding the piercing object (foreign body) under the skin. Research shows that complications can be prevented if the patient seeks professional treatment right away.
Foreign Bodies in Puncture Wounds
A variety of foreign bodies can become embedded in a puncture wound. Nails, glass, toothpicks, sewing needles, insulin needles, and seashells are some common ones. In addition, pieces of your own skin, sock, and shoe can be forced into the wound during a puncture, along with dirt and debris from the object. All puncture wounds are dirty wounds because they involve penetration of an object that isn't sterile. Anything that remains in the wound increases your chance of developing other problems, either in the near future or later.
Severity of Wounds
There are different ways of determining the severity of a puncture wound. Depth of the wound is one way to evaluate it. The deeper the puncture, the more likely it is that complications such as infection will develop. Many patients cannot judge how far their puncture extends into the foot. Therefore, if you've stepped on something and the skin was penetrated, seek treatment as soon as possible.
The type and the cleanliness of the penetrating object also determine the severity of the wound. Larger or longer objects can penetrate deeper into the tissues, possibly causing more damage. The dirtier an object, such as a rusty nail, the more dirt and debris are dragged into the wound, increasing the chance of infection.
Another thing that can determine wound severity is if you were wearing socks and shoes, particles of which can get trapped in the wound.
A puncture wound must be cleaned properly and monitored throughout the healing process to avoid complications.
Even if you have gone to an emergency room for immediate treatment of your puncture wound, see a foot and ankle surgeon for a thorough cleaning and careful follow-up. The sooner you do this, the better: within 24 hours after injury, if possible.
The surgeon will make sure the wound is properly cleaned and no foreign body remains. He or she may numb the area, thoroughly clean inside and outside the wound, and monitor your progress. In some cases, x-rays may be ordered to determine whether something remains in the wound or if bone damage has occurred. Antibiotics may be prescribed if necessary.
Follow the foot and ankle surgeon's instructions for care of the wound to prevent complications (see Puncture Wounds: What You Should Do).
Infection is a common complication of puncture wounds that can lead to serious consequences. Sometimes a minor skin infection evolves into a bone or joint infection, so you should be aware of signs to look for. A minor skin infection may develop in two to five days after injury. The signs of a minor infection that show up around the wound include soreness, redness, and possibly drainage, swelling, and warmth. You may also develop a fever. If these signs have not improved, or if they reappear in 10 to 14 days, a serious infection in the joint or bone may have developed.
Other complications that may arise from the inadequate treatment of puncture wounds include painful scarring in the area of the wound or a hard cyst where the foreign body has remained in the wound.
Although the complications of puncture wounds can be quite serious, early and proper treatment can play a crucial role in preventing them.
Puncture Wounds: What You Should Do
Get a tetanus shot if needed (usually every ten years).
See a foot and ankle surgeon within 24 hours.
Follow your doctor's instructions:
Keep your dressing dry.
Keep weight off of the injured foot.
Finish all your antibiotics (if prescribed).
Take your temperature regularly.
Watch for signs of infection (pain, redness, swelling, fever). Call your doctor if these signs appear.
Dr. Vaughn is THE best doctor I have ever met. Very personable, not in a rush, took time to thoroughly explain my problem and the treatment for it. He even helped calm my nerves over taking the medication prescribed to me. Fantastic doctor. Compelled me to write this because the experience left me with such a positive attitude for the rest of my day. The medical assistant was the bomb, too! She was absolutely relatable, friendly, funny, and took my mind off the pain! Thank you for treating me with so much kindness! I hope you guys see this.
- Britt T. 2/10/2020
Dr simonson is terrific! I went to 3 podiatrists in melbourne....no one found the problem with my foot....he found it in 5 minutes!!! I got a shot...he was so personable and funny and made me feel at ease...because of him...im not limping anymore!!! Thank you Dr. Simonson!
- Margie I. 2/7/2020
I went to a podiatrist for four months for plantar fasciitis. They never explained anything had me by expensive footwear and gave me several injections. I researched for another doctor and found Dr Simonson. Immediately I saw a difference he explained everything step by step to me. I had a simple procedure and I was back on my feet in four weeks. His office staff was lovely minimal wait time. I am so happy I found a realistic and compassionate doctor in my trying time.
- Vanessa Thompson. 0/6/2020
Dr. Simonson & Staff are efficient, providing excellent care and service. I started having issues shortly after our last podiatrist retired. Simonson was my 4th opinion. He assessed my situation thoroughly, offered options to resolve and helped me navigate options that eventually ended in routine surgery. The procedure went well. The pains are gone and I'm almost back to jogging!
- Valerie Citta. 3/12/2019
This is the first time visiting Dr Simonson's office . Called this morning and was seen the very same day as a new patient.
The Receptionist was VERY pleasant and accommodating. I must say the entire staff was professional and pleasant. I was extremely fortunate to get an appointment to see Dr. Vaughn today.
This is the best experience I had since moving to FL with doctors. He's extremely polite, professional and compassionate. He also made me more at ease with his diagnosis LOVED HIM!!!!I
Thanks again Dr Vaughn you are nothing but the BEST!
- Bella Kam. 1/25/2019
You would have never thought that the best was actually so close to home. After shopping around a lot, I'm glad I made the choice to come here to get my toenail removed.
- Bill Gates. 10/8/2018
Wow we went to see Dr. Vaughn today- and it was my best experience with our child with a doctor in my life. What a personable, knowledgeable, just wonderful doctor he is! I called this morning for an appointment short notice and they saw us right away. I highly recommend them!!!
- J. J.. 9/19/2018
Dr. Simonson is a wonderful doctor. I went in with balance issues and right away he asked about ankle sprains, of which I’ve had many. He moved my ankle around and found I had two torn tendons. He sent my for an MRI and he operated a few weeks later. I have a cute little scar on my ankle and I can walk much better. Dr. Simonson practiced under a plastic surgeon during his residency and is quite skilled at minimizing scars. He’s the best!
- Diane Cook. 5/20/2018
Went to him after a few years of complaining of knee and ankle pain. He said he thought it was more of a back issue. I went to a neurologist and had a MRI that revealed a severe hernia in my lower back. Prepping for surgery to relieve the pain I’ve had for several years. Thank you 🙏🏼
- Meredith Ott. 3/11/2018
Friendly staff and a fantastic and personable doctor. He diagnosed and treated my foot problem on my first visit. He was empathetic and competent. I highly recommend this practice.
- Michelle Lee. 7/2/2017
Dr Simonson did tendon rrpair surgery on my foot after conservative treatment failed. He did an excellent job. He is knowledgeable and friendly. Office staff is pleasant. My only negative is he is frequently behind appt times, but, in fairness to that, he spends time with his patients, answers questions and explains procedures well. Would recommend without hesitation.
- Angel Collins. 6/20/2017
- stephanie schobel. 1/22/2017
Feels like you are talking to a friend not a doctor.
- Charles Putnam. 5/20/2016
Best podiatrist in town! 👍🏻
- Josh Light. 1/21/2016
My husband had an ingrown toenail removed and it was done quickly and professionally. We would recommend this DPM Office for this procedure.