Puncture wounds of the foot are described as partial or full thickness.
Partial thickness puncture wounds of the foot do not penetrate the deepest layer
of the skin called the dermis. Full
thickness puncture wounds of the foot do penetrate the dermis. Full
thickness puncture wounds of the foot can be particularly difficult to treat. We’ll
often see material from the sock or inside of the tennis shoe driven into the
wound. A full thickness puncture wound of the foot can result in a rather complex bacterial infection.
In addition to the thickness of the puncture, wounds are also classified as
to clean or dirty. An example of a clean wound would be a puncture from a piece of glass
in the kitchen. An example of a dirty wound would be a rusty old nail out
in the yard. Each and every puncture, whether
clean or dirty, should force you to review your previous immunizations for
tetanus. Tetanus is a bacteria that is commonly found in the ground and can have
some serious consequences if left untreated. When considering tetanus, a clean
wound should have a tetanus booster within the past 10 years and a dirty wound,
less than five years.
Wound healing is very dependant upon the general health status of the
patient. Factors that contribute to poor wound healing include
poor circulation (PAD),
diabetes, obesity,
diabetic peripheral neuropathy, smoking and poor nutritional status.
Patients who sustain a puncture wound of the foot and have any of these
comorbidities should seek the care of their doctor.
Treatment of Puncture Wounds of the Foot
Prevention of puncture wounds is as simple as using the right type of shoes
for each specific activity. For instance, don’t go to a construction job site in tennis shoes.
And don’t work in the garden in a pair of flip flops.
If a puncture wound of the foot does occur, follow these treatment
guidelines;
- Wash the wound in lots of soap and water. And then wash it again.
It's important to clean the wound before the wound seals over with a scab. Try to clean the wound
of all loose debris. Soaking the foot in Epsom’s SaltsÔ
and the use of a topical antibiotic will help. If the wound shows
any signs of infection such as redness or increased pain, please contact
your doctor for an antibiotic.
- Repeat cleaning the wound every day with soap, water and a washcloth.
Does every puncture wound of the foot need an antibiotic? No, not
necessarily. If the would is clean and the patient is in good health,
there's a strong likelihood that the wound will not become infected. If
the patient is older or in any way immune compromised, an antibiotic would be
required as soon as possible. In many cases, the wound can be monitored
for several days keeping a eye out for signs of infection. These signs
would include and increase in pain, redness, swelling or drainage. Red
streaks rising from the wound (lymphangitis) or painful regional lymph nodes
(lymphadenopathy) are also signs of an infection and a need for immediate
medical care and antibiotic treatment.
If you have any questions about the wound or suspect an infection, please
contact your doctor for follow-up.
