Conservative therapy of plantar puncture wounds.

In order to define the natural history and complication rate of plantar puncture wounds receiving conservative initial therapy, a prospective, uncontrolled case series study with standardized protocol was conducted in a university hospital emergency department. The eligible patients were between the ages of 18-59 years and presented within 24 hours of sustaining an uncomplicated plantar puncture wound without preexisting impediments to wound healing or wound assessment. Patients were treated with surface cleansing alone and were kept non-weight bearing for 24 hours. Patients were followed by telephone at 48 hours, 1 week, 1 month, and 6 months. Five infections and two retained foreign bodies occurred in 63 patients, for a complication rate of 11.9%. Only the presence of symptoms 48 hours postinjury was associated with a higher risk of complication. No findings at initial presentation predicted a subsequent complication.