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Cuts and puncture wounds

Definition

A cut, also called a laceration, is a break or opening in the skin. The cut may be deep, smooth, or jagged. It may be near the surface of the skin, or affect deep tissues, such as 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).

Alternative Names

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

Considerations

Causes

Symptoms

Infection may occur with some cuts and puncture wounds. The following types 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 911.

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

FOR MINOR CUTS

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

FOR MINOR PUNCTURES

1. Wash your hands with soap or antibacterial cleanser to prevent infection.
2. Use a stream of water for at least 5 minutes to rinse the puncture wound, then wash with soap.
3. Look (but do NOT probe) for objects inside the wound. If found, DO NOT remove -- go to the Emergency Department. If you cannot see anything inside the wound, but a piece of the object that caused the injury is missing, also seek medical attention.
4. 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. 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 embedded object. Seek medical attention.
• Do NOT probe or pick debris from a wound. Seek medical attention.
• Do NOT push exposed body parts back in. Cover them with clean material until medical help arrives.

Call immediately for emergency medical assistance if

Call 911 if:

• The bleeding is severe, spurting, or cannot be stopped (for example, after 10 minutes of pressure).
• There is impaired function or feeling from the cut.
• The person is seriously injured.

Call your doctor immediately if:

• The wound is large or deep, even if the bleeding is not severe.
• You think the wound might benefit from stitches (the cut is more than a quarter inch deep, on the face, or reaches bone).
• 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 embedded -- DO NOT remove it yourself.
• The wound shows signs of infection (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.

Prevention

Keep knives, scissors, firearms, and breakables 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

Hollander JE, Singer AJ. Evaluation of wounds. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. Columbus, OH:McGraw-Hill;2006:chap 40.