Cuts and puncture wounds
Wound - cut or puncture; Open wound; Laceration; Puncture wound
A cut is a break or opening in the skin. It is also called a laceration. A cut may be deep, smooth, or jagged. It may be near the surface of the skin, or deeper. A deep cut can affect 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. Puncture wounds often appear to be on the surface, but may extend into the deeper tissue layers.
The essentials of a good first aid kit include a variety of bandages, medications, and equipment to stabilize injuries until proper medical attention can be administered.
A laceration is a wound that is produced by the tearing of soft body tissue. This type of wound is often irregular and jagged. A laceration wound is often contaminated with bacteria and debris from whatever object caused the cut. A puncture wound is usually caused by a sharp pointy object such as a nail, animal teeth, or a tack. This type of wound usually does not bleed excessively and can appear to close up. Puncture wounds are also prone to infection and should be treated appropriately.
Stitches are primarily used if the cut is more that a quarter inch deep, is on the face, or reaches bone. Stitches help hold the wound together so it can heal properly. Stitches are removed between 3 to 14 days after they are put depending upon which area of the body was injured. Stitches on the face can be removed within 3 to 5 days but areas of high stress such as hands, elbows, and knees must stay in 10 to 14 days.
Venomous snake bites are medical emergencies and require immediate attention. A venomous snake bite can cause severe local tissue damage and often requires follow-up care. The right anti-venom can save a person's life. Even though most snakes are not venomous, avoid picking up or playing with any snake unless you have been properly trained.
To treat a minor cut at home first wash your hands thoroughly with soap to avoid infection. Next wash the cut with mild soap and water.
Grip a suture needle securely using a needle driver instrument.
Symptoms
Symptoms include:
- Bleeding
- Problems with function (movement) or feeling (numbness, tingling) below the wound site
- Pain
Infection may occur with some cuts and puncture wounds. The following are more likely to become infected:
- Bites
- Punctures
- Crush injuries
- Dirty wounds
- Wounds on the feet
- Wounds that are not promptly treated
First Aid
If the wound is bleeding severely, call 911 or the local emergency number.
Minor cuts and puncture wounds can be treated at home. Prompt first aid can help prevent infection and thereby speed healing and reduce the amount of scarring.
Take the following steps:
FOR MINOR CUTS
- Wash your hands with soap or antibacterial cleanser to prevent infection.
- Then, wash the cut thoroughly with mild soap and water.
- Use direct pressure to stop the bleeding.
- Apply antibacterial ointment and a clean bandage that will not stick to the wound.
FOR MINOR PUNCTURES
- Wash your hands with soap or antibacterial cleanser to prevent infection.
- Rinse the puncture for 5 minutes under running water. Then wash with soap.
- Look (but do not poke around) for objects inside the wound. If found, don't remove them. Go to your emergency or urgent care center.
- If you can't see anything inside the wound, but a piece of the object that caused the injury is missing, also seek medical attention.
- 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. Always 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 stuck object. Seek medical attention.
- Do not push or pick debris from a wound. Seek medical attention.
- Do not push body parts back in. Cover them with clean material until medical help arrives.
When to Contact a Medical Professional
Call 911 or the local emergency number if:
- The bleeding is severe or cannot be stopped (for example, after 10 minutes of pressure).
- The person cannot feel the injured area, or it doesn't work right.
- The person is otherwise seriously injured.
Contact your health care provider right away if:
- The wound is large or deep, even if the bleeding is not severe.
- The wound is more than a quarter inch (0.64 centimeter) deep, on the face, or reaching the bone. Stitches may be needed.
- 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 stuck. Do not remove it yourself.
- The wound shows signs of infection such as warmth and redness in the area, a painful or throbbing sensation, fever, swelling, a red streak extending from the wound, or pus-like drainage.
- You have not had a tetanus shot within the last 10 years.
Prevention
Keep knives, scissors, sharp objects, firearms, and fragile items out of the reach of children. When children are old enough, teach them to how to use knives, scissors, and other tools safely.
Make sure you and your child are up to date on vaccinations. A tetanus vaccine is generally recommended every 10 years.
References
Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, et al. Skin, hair, and nails. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 9.
Lammers RL, Aldy KN. Principles of wound management. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 34.
Simon BC, Hern HG. Wound management principles. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 52.
Version Info
Last reviewed on: 11/2/2023
Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
