Puncture Wounds of the Foot

What Is The Difference Between A Cut And Puncture Wound?

Puncture wounds and cuts are both different. A puncture wound occurs when a sharp pointed object pierces the skin creating a small hole in the foot. Puncture wounds usually occur when the person steps on sharp-edged nails. Cuts are nothing but the lengthy tearing of the skin. Puncture wounds need serious treatments rather than cuts because the small holes can carry the infections into the deeper layers of the tissue.

How To Determine the Severity Of the Wound?

The severity of the puncture wounds is determined by the following:

• Depth Of the Wound: Deeper wounds cause more damage and lead to complications such as infections. Moreover, patients cannot record the depth of the wound. Hence it is recommended to seek medical advice as soon as possible.

• Puncturing Object: Wound severity can be estimated on the category and the neatness of the puncturing object. Bigger objects, rusted nails could cause more severe injury.

How To Treat A Puncture Wound At Home?

After noticing the puncture wounds, immediate care must be taken to avoid further complications. The following steps should be taken care of:

Wound Cleaning:

• Quick washing of the wound with soap and water is advised.

• If there is availability of warm water, then it is advised to wash the wound with warm water continuously for about 15 minutes.

• The surrounding area around the wound should also be kept clean and neat. Any dirt or grime around the wound should be thoroughly cleaned with the help of a scrub.

• Then a moistened cloth is used to remove any leftover scum or dirt around the wound.

• After a thorough wash, apply gentle pressure on the wound to stop the bleeding, and continue to apply pressure till the bleeding stops. Bleeding lets out the bacteria from the wound.

Wound Dressing:

• Once the bleeding is stopped, an antibiotic ointment is applied over the wound with a neat and clean finger. Usually, these antibiotic ointments are available as over-the-counter medications, and no prescription from the doctor is required.

• Then the wound is covered with bandages that are commercially available in medical stores. This prevents further infection of the wound.

• The bandage should be neat and sterile. If not, this further causes the wound to re-infect.

• The bandage should be changed every 6 to 12 hours. The wound should be thoroughly cleaned, and a new bandage should be reapplied over the wound for about 2 to 3 days.

Medications:

• Antibiotics and pain medications are suggested depending on the site and size of the wound. Antibiotics are advised to prevent further infection.

• Wound Healing: Wound healing occurs in various stages, and the pain usually vanishes within 2 to 3 days.

• Observation: During this phase, the person must clearly check for signs of infection like pus formation, continuous pain, swelling, and redness around the wound. If any such symptoms are noted, the patient must immediately address the doctor.

When To Seek A Doctor's Help?

Immediate medical care is advised in the following conditions:

• If bleeding occurs continuously, even after applying pressure.

• If the puncture is caused by any metal object.

• If the wound is because of a human bite or animal bite.

• High body temperature with no previous history of tetanus injection.

• And if the wound is deep, causing damage to nerves and major blood vessels.

At the wound puncture, the person is advised to have a booster dose of tetanus vaccination within 24 to 48 hours after the injury.

How Does Wound Healing Occur?

The wound usually occurs in four stages. The wound area should be kept neat, clean, and covered to prevent re-infections and fasten the healing process.

• Stage 1: In this stage, hemostasis (blood clotting) is achieved. Clot formation begins immediately within seconds to minutes after the injury. This is an important step as clot formation prevents the further loss of the blood. Clotting also protects the wound from further exposure to the environment and re-infection.

• Stage 2: In this stage, scab formation takes place. The blood clot over the wound dries up and leads to scab formation. This usually takes place within 2 to 5 days after the injury. Scabbing protects the underlying tissues from germs and also prevents the wound from further infection. At this stage, the wound appears to be swollen and red in color. During this stage, a small amount of liquid oozes out of the wound, which helps in cleaning the area around the wound. Blood vessels in this area carry a sufficient amount of nutrients and oxygen that help in the healing process. Leucocytes (white blood cells) invade the site of injury and start the repairing process.

• Stage 3: This stage is also called the rebuilding stage and occurs within 3 weeks after the initial injury. The wound appears to shrink in size, and red color scar formation is seen where the red color slowly fades out. Collagen acts as a platform for the regeneration of new tissues at the site of injury; hence this stage is also called the regenerative and proliferative phase.

• Stage 4: At this stage, the wound gets strengthened and matured. Healing continues to take place, and the scab formed in stage 2 shreds off. Itching, stretching, and redness can be noticed around the wound. The color of the wound changes to bright red and appears to be shiny. Scars will slowly disappear over a period of time, but some scars do not go away totally.

The new tissue formed over the wound is completely different from that of the existing old tissue. This difference leads to scar formation. Injury over the top layers does not leave a scar, but an injury to the deeper layers of the tissues leads to scar formation.

How to Prevent Puncture Wounds of the Foot?

The foremost way of preventing punctured wounds of the foot is to wear footwear. The footwear must be properly fitted onto the foot with a suitable size. It is advised to wear footwear inside and outside the house, especially for children and also for people who have a loss of sensation in their feet.

Conclusion:

All the punctured wounds of the foot must be thoroughly assessed and treated accurately to prevent the chances of any complications. A planned approach to treat puncture wounds would end up in a good prognosis and satisfactory results for both patient and the doctor.