RT Book, Section A1 Fitch, Michael T. A2 Cydulka, Rita K. A2 Fitch, Michael T. A2 Joing, Scott A. A2 Wang, Vincent J. A2 Cline, David M. A2 Ma, O. John SR Print(0) ID 1143139824 T1 Puncture Wounds and Bites T2 Tintinalli's Emergency Medicine Manual, 8e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071837026 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1143139824 RD 2024/03/29 AB Puncture wounds can be challenging to manage due to difficulty visualizing and cleaning the full depth of an injury. These injuries commonly occur to the extremities, such as on the plantar surface of the foot. Puncture wounds also include injuries caused by high-pressure injection equipment, health care associated needle-stick injuries, and some bite wounds from animals. Infections are reported in 6% to 11% of puncture wounds, with Staphylococcus aureus predominating (including methicillin-resistant S. aureus—MRSA). Pseudomonas aeruginosa is the most common pathogen in post-puncture wound osteomyelitis, particularly when penetration occurs through the sole of an athletic shoe. Post-puncture wound infections despite treatment with antibiotics suggest the possibility of a retained foreign body.