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By Dr. Brian Richman
This is a newspaper article I wrote on the treatment of puncture wounds for the Standard
Examiner Ogden, Utah ( Lakeside Review ) on Aug 25, 1997.
Lower extremity puncture wounds are common, especially during the summer months
when more people tend to go barefoot. These type of wounds can be a difficult problem for both
the physician and the patient if left untreated and/or mistreated. Objects like nails, glass, sharp
metal objects, toothpicks, toys, and sewing needles contain bacteria which make puncture wounds
very opportunistic for infection. High-risk patients include construction workers, people with
diabetes, children, seamstresses and family members, and anyone going barefoot.
Treatment for puncture wounds include:
(1) Seeing a physician immediately; any delay in treatment can lead to a possible complication like
amputation.
(2) Tetanus prophalxis
(3) X-rays to rule out bone involvement and location of foreign body.
(4) Surgery incision and drainage procedure to drain abscess or potential abscess and / or
removal of foreign body. The incision and drainage procedure is important to open the
puncture wound site to allow drainage and decrease the potential for infection.
(5) Oral and/or IV antibiotics.
(6) Hospitalization if necessary.
(7) Non-weight bearing with crutches.
(8) Local wound care.
Many people with diabetes have some form of decreased sensation or neuropathy in their
lower extremities. A loss of feeling makes the diabetic patient more susceptible to complications
from puncture wounds because treatment is often delayed.
People can avoid puncture wounds by picking up construction nails and 2 x 4's with
protruding nails. Wear protective shoe gear and gather up broken glass. Use your hand to feel
inside your shoes to avoid any foreign objects. Be careful around sewing areas, avoid going
barefoot, and beware of any potential hazards. |