puncture wound

History

• circumstances surrounding puncture wound Physicial examination:
• neurologic examination to assess damage to peripheral nerve or spinal cord (dependent upon location)

Radiology

• plain films to rule out retained foreign body
  • note wood splinters will not show up on X-ray
• ultrasound may identify wood splinters & other radiolucent retained foreign bodies

Complications

• infection
  • cellulitis & other soft tissue infections
  • osteomyelitis
• neurologic injury

Management

• tetanus immunization as needed (dT)
  • if dirty, contaminated wound, add tetanus immune globulin*
    • if unknown immunization history, TdAP + tetanus immune globulin
• antibiotics if bacterial contamination not removed with wound care likely

* do not administer IV or in same syringe as tetanus toxoid

More general terms

• wound

More specific terms

• needle stick

Additional terms

• puncture