Puncture Wound

Scenario:
A puncture wound means you impaled yourself on some foreign body. In mountain biking, this usually doesn't mean stepping on a nail. It means skewering yourself on a stiff twig while riding at high speed, or falling onto something long and thin.

Description:
Puncture wounds that penetrate into the fatty tissue can cause serious problems. Sometimes foreign matter, or even a chunk of your own skin, is shoved down into the wound. Infection is common. Chainring punctures are usually contaminated with grease and dirt. Note the black material -- it's actually showing through the skin from contamination of the deep dermis. This will leave a permanent tattoo if it isn't cleaned out!
Contaminated puncture wound on the face.
Contaminated puncture wound on the face.

Concerns:
The puncturing object can injure an artery, nerve, or tendon. It's hard for a non-physician to be sure he's checked everything out. And any time a foreign object penetrates under your skin, there's contamination. These injuries have a high liability for complications such as infection.

See the doctor if:
    - there's deep pain
    - there's numbness or tingling
    - joints nearby don't have full mobility
    - you suspect contamination
    - there's continued bleeding

Immediate care:
If the puncturing object is still there, stabilize the foreign body in place. (Remove it only if it's the only way you can get back to civilization.) Squirt Betadine solution around the foreign body. Wad up some roll gauze and place it around the foreign body to stabilize it, then gently wrap the gauze around the extremity. Don't move the object. Go to the doctor or emergency room.

If there are signs of serious injury (see above) go to the doctor. You should also strongly consider getting medical help for foot punctures, especially if a nail went through your smelly sweaty sneaker. If you plan to treat the puncture wound at home, wash the area well with soap and water. Put antibiotic ointment on the wound and bandage it.

Ongoing care:
Inspect the area daily for signs of infection.