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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
| Section 6. Emergency Wound Management > |
Chapter 50. Puncture Wounds and Bites
Sections: Puncture Wounds, Mammalian Bites, References.
Excerpt:"Puncture wounds are defined as wounds whose depth exceeds the
diameter of the visible surface injury. They most commonly involve
the plantar surface of the foot.1 The relatively
innocuous-appearing skin wound belies the potential for infection
and injury to underlying structures. Puncture wounds caused by high-pressure
injection equipment, animal bites, and those involving exposure
to body fluids each have the potential for unique complications
that affect ED evaluation and management.In puncture wounds, shear forces between the penetrating object
and tissue result in tissue disruption, producing hemorrhage and
devitalization of skin and underlying tissues. Inoculation of organisms
from the object (with or without leaving behind a subdermal foreign
body) or from the skin surface into the deeper tissues is followed
by relatively rapid closure of the small skin wound, creating an
environment favorable for the development of infection as evidenced
by the reported infection rate from plantar puncture wounds of approximately
6% to 11%.2,3..."
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