From the Guidelines
For a nail puncture wound, thorough cleaning of the wound with soap and water is essential, followed by wrapping the wound in a sterile wet dressing, as recommended by the most recent guidelines 1. The goal of treatment is to prevent infection and promote healing, with a focus on minimizing morbidity, mortality, and improving quality of life. Key steps in managing a nail puncture wound include:
- Cleaning the wound with a large volume of warm or room temperature potable water with or without soap until there is no foreign matter in the wound, as suggested by earlier guidelines 1.
- Allowing the wound to bleed briefly to help flush out contaminants.
- Applying gentle pressure with a clean cloth to stop bleeding.
- Covering the wound with a sterile bandage, changing it daily or when soiled, and considering the use of a topical antibiotic to keep the wound moist and prevent drying 1.
- Monitoring for signs of infection, including increasing pain, redness, swelling, warmth, pus, or red streaks extending from the wound.
- Seeking medical attention promptly if the wound is deep, dirty, or if tetanus prophylaxis is needed, especially for individuals with certain health conditions or those who haven't had a tetanus shot within the recommended timeframe. The most recent guidelines from 2021 1 emphasize thorough cleaning and wrapping the wound in a sterile wet dressing, which should be prioritized in the treatment approach.
From the Research
Treatment for Nail Puncture Wound
- The treatment for a nail puncture wound includes cleansing the wound, debridement of any necrotic or devitalized tissue, and appropriate immunoprophylaxis 2.
- It is essential to evaluate the severity of the lesion and determine whether it is necessary to attend a health center or not 3.
- For simple wounds, the recommended course of action is cleansing with serum or water after washing one's hands, followed by wound disinfection with the most appropriate antiseptic 3.
- All inorganic residues (foreign bodies) and dead tissue should be removed before an antiseptic is applied to aid healing and the action of antiseptics 3.
- Antibiotic treatment should be started immediately in cases of hand and puncture wounds, especially if there is a risk of infection 4.
- For nail puncture wounds through a rubber-soled shoe, treatment may involve conservative management or surgical intervention, depending on the severity of the wound and the presence of foreign bodies 5.
- In some cases, ultrasonography may be useful in detecting the presence of a foreign body in the wound 5.
- It is crucial to be aware that complications of nail puncture wounds, such as infections, may require surgical intervention and parenteral antibiotics 6.