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11.07 Pencil Point Puncture


The patient will tell you that he was stabbed or stuck with a sharp pencil point. He may be overtly or unconsciously worried about lead poisoning. A small puncture wound lined with graphite tattooing will be present The pencil tip may or may not be present, visible, or palpable If the puncture wound is palpated, an underlying pencil point may give the patient a foreign body sensation.

What to do:

What not to do:


In order to reduce the amount of tattooing, the wound may be anesthetized and scraped (dermabraded) with the tip of a scalpel blade. It is unwise to excise the entire wound because the resultant scar might be more unsightly than the tattoo. If a superficial pencil-tip foreign body exists, then see subcutaneous foreign body for an easy removal technique. Deep punctures and/or foreign bodies may require exploratory surgery in the operating room.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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