WHAT IS A PUNCTURE WOUND?
A Puncture wound is a forceful injury caused by a sharp pointed object that goes into the skin. A Puncture wound is usually narrower and deeper than a cut or scrape. Many people get Puncture wounds by an accident from household items, work items, yard tools or when operating machine machinery. Most Puncture wounds are minor and minimal treatment is all that is needed.
WHAT ARE THE CONSEQUENCES OF A PUNCTURE WOUND?
Sharp objects such as glass, nails, thumbtacks, ice packs, knives, teeth and needles can all cause Puncture wounds. These types raise your risk of infection because they are hard to clean and they provide a warm moist place for bacteria to grow. Pseudomonas bacteria is a common cause of an infection when a person’s foot gets punctured through the sole of a shoe. Pseudomonas is considered a “Gram-negative bacteria” and will respond better to certain antibiotics such as Ciprofloxacin. It will NOT respond well to the Penicillin derivative antibiotics, including Cephalosporins such as Keflex.
If the wound is dirty and the patient has not had a Tetanus shot within 10 years then a Tetanus booster is advisable. Otherwise, bad complications may develop, including “lock-jaw”, where the neck and jaw muscles do not fire properly and go into spasm.
WHAT ARE SOME GOOD TREATMENTS?
Here is the protocol to treat a Puncture wound:
1. Wash your hands.
2. Stop the bleeding. Apply pressure for up to 10 minutes with a bandage or use a styptic solution to stop the bleeding. It is a good idea to elevate the area as high as possible to make it harder for the blood to get there.
3. Clean the wound. It is good to use Hydrogen Peroxide initially for a good cleaning, and this will also aerate the wound and prevent anaerobic bacteria from populating the wound. Do not continue to use the Peroxide after the initial cleaning as it can actually slow down wound healing. Instead, use mild soap and water, sterile saline or Colloidal Silver to clean the wound prior to bandaging.
4. Apply topical antibiotic ointment to the area, cut out a square of sterile gauze, and then apply tape or band-aid to cover the wound. Prior to applying the ointment, I recommend using Gentian Violet 1 percent solution to help
dry the wound out and lessen chances of infection. Just be careful in using it since it is very messy. My advice is to use a floor towel and apply the solution in the bathroom or outdoors and not near any carpet.
5. Change the dressing twice daily to keep the area fresh and prevent it from getting too macerated under the bandage. That is why it is important to place a sterile gauze over the antibiotic ointment before applying the covering to help it “air out” under the bandage while still being protected.
6. Look for signs of infection such as pain, presence of pus, redness, and swelling. If a fever develops, one should seek medical attention immediately at the Emergency Room.
One should also seek medical care if the area continues bleeding, is due to an animal or a human bite, is deep and dirty, is caused by a metal object or is over a joint and could possibly go deep into the joint.
Medical care is also needed in the presence of a fever, redness, swelling, warmth, increasing pain around the wound, a bad smell coming from the wound, pus coming from the wound or red streaks around the wound going away from the wound. These are all signs of an infection and will need an oral antibiotic after a culture is taken to identify the bacteria.
If the wound is caused by a cat or a dog, try to confirm the animal’s Rabies vaccination status. If it was caused by a wild animal, seek advice from a healthcare professional as to which animals are potentially higher risk for carrying rabies. One example of that is a raccoon.
WHAT ARE SOME OF DR. RICHARD RIMLER’S SOLUTIONS?
Although I am a Holistic Podiatric Physician, when it comes to infections, I use conventional topical and oral antibiotics as my standard of care. What I will do that is different is also recommend my patients take a 50 billion CFU Probiotic to offset the potential side effects of an antibiotic, whereby the good bacteria is killed off in your gut leading to diarrhea. I will typically recommend a dose of 100 to 150 billion CFU per day while taking an antibiotic, which typically is a 10 day course of treatment.
I will also recommend natural antibiotics in conjunction with the traditional ones. A few examples are Colloidal Silver and Manuka Honey. Colloidal Silver consists of “Nano particles” of Silver, which can naturally fight bacteria, viruses, fungi and yeast. Because of their small size, there is no potential for excess accumulation in the body or untoward side effects. A typical regimen for Colloidal Silver would be 20 sprays under the tongue,
held for 30 seconds and then swallowed down with a glass of water two times daily. You can also take a liquid form using 1 teaspoon as your dose 2 times daily. Manuka Honey is a special type of honey that is found in New Zealand harvested from local bees. A typical dose of Manuka Honey would be 1 tablespoon twice daily. Both of these antibiotics do NOT have any bacterial resistance since they are natural. This is in stark contrast to the current environment of Staphylococcus bacteria that are resistant to both Penicillin and Methicillin, also referred to as “MRSA” infection.
In summary, Puncture wounds are much easier to deal with if treatment is given immediately after the incident. This will keep the wound clean and covered, and therefore less likely to develop an infection. I recommend to carefully observe the area for the first 3 days after the injury for any signs of an infection developing and to act quickly if that is the case. Early on, a visit to your Podiatrist or Primary Care Physician would be a good starting point to assess the situation. If it is severe, a visit to the ER or Urgent Care is certainly warranted.
I encourage you to book an office visit or teleconsultation so I can put you on a safe path to wellness. Any treatments mentioned should only be used after a one to one personal evaluation, do not start any kind of treatment without first consulting your doctor.
