In this section Cypress Foot and Ankle Expert Dr. Christopher Correa discusses puncture wounds. Some of the most common foot injuries seen in podiatry clinics are ones where an object penetrates through the skin. These penetrating injuries are considered unique in the sense that the depth and narrow track of the wound cause dirt, debris and bacteria to get trapped deep within the wound. This is significant because the wound track swells and “seals” closed within about 2 hours of injury. If the wound is no sufficient clean and all remaining foreign material removed, it can allow the bacteria to grow and allow the wound to fester. This is in stark contrast to cuts which readily allow for draining and flushing the area reducing the overall bacterial load. Due to this deep puncture wounds carry about a 10% chance of infection if left untreated and even higher if the injury happens in a dirty environment or from a contaminated object. Factors that increase the risk of complications from puncture wounds are:
A puncture to the foot through a sock or shoe.
Animal or human bite.
Retention of a foreign object deep in the wound (glass, splinters, dirt etc).
Injury in a dirty location like the ocean, lake, or in a field or cow pasture.
Penetration to joint or bone.
No tetanus shot in the last 5 years.
Uncertainty about the presence of a deep foreign body.
Uncertainty about how deep the object entered the foot.
Puncture wounds need to be watch carefully because often times the wound may seem to improve initially within the few days only to worsen thereafter. To prevent infection, especially in the above-named circumstances, seeing a specialist quickly after the puncture and having the wound irrigated and starting antibiotics can significantly reduce complications. If going to a specialist is not an option, then immediately cleaning the area with soap and water and local first aid is generally advised. Apply a topical antibiotic like polysporin and keep the wound dry and covered and P.R.I.C.E. therapy. Soaking of deep penetrating injuries is not generally by recommended by medical professionals. Seek out a specialist as soon as possible for assessment immediately for deep punctures or superficial puncture wounds that worsen or fail to improve over the course of the following week. While severe cases may require surgical irrigation and debidement to clear a deep space infection or remove foreign material, most puncture wounds with early proper treatment often heal with minimal complications. If you recently suffered a puncture wound, make an appointment with the experts at Select Foot and Ankle Specialists today and take the first step towards recovery!
