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.

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.

Open References

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.

First aid kit - illustration
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.
First aid kit
illustration
Laceration versus puncture wound - illustration
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.
Laceration versus puncture wound
illustration
Stitches - illustration
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.
Stitches
illustration
Snake bite - illustration
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.
Snake bite
illustration
Minor cut - first aid
Presentation

<strong>Minor cut - first aid</strong><p>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.</p>

<strong>Procedure, part 2</strong><p>Apply direct pressure to stop the bleeding.</p>

<strong>Procedure, part 3</strong><p>Apply an antibacterial ointment to coat and protect the wound.</p>

<strong>Procedure, part 4</strong><p>Once the wound has stopped bleeding cover it with a bandage that will not stick to the injury. </p>

Sewing a wound closed
Presentation

<strong>Sewing a wound closed</strong><p>Grip a suture needle securely using a needle driver instrument.</p>

<strong>Sewing a wound closed, part 2</strong><p>Push the needle through the skin and into the base of the wound. Then pull the suture through the first side of the wound.</p>

<strong>Sewing a wound closed, part 3</strong><p>Push the needle through the base of the opposite side of the wound and bring it out as before. Tie the suture to close the wound.</p>

<strong>Sewing a wound closed, part 4</strong><p>When the suture is properly in place, it should form a U-shape.</p>

<strong>Sewing a wound closed, part 5</strong><p>To tie a suture, first loop it around the needle driver twice. Next, grab the short end of the suture with the needle driver.</p>

<strong>Sewing a wound closed, part 6</strong><p>Start by creating the first knot of a loop. Next, make a second single loop in the opposite direction. This completes the square knot.</p>

First aid kit - illustration
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.
First aid kit
illustration
Laceration versus puncture wound - illustration
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.
Laceration versus puncture wound
illustration
Stitches - illustration
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.
Stitches
illustration
Snake bite - illustration
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.
Snake bite
illustration
Minor cut - first aid
Presentation

Sewing a wound closed
Presentation

A Closer Look

Wounds

Self Care

Tests for Cuts and puncture wounds

Review Date: 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.

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