I got a puncture wound on my hand a week

Get this hand looked at in person today — a clinic visit today, not home observation. A hand puncture that is already a week old, with you watching it for redness and streaks, is exactly the kind of thing a clinician needs to look at today: they check whether something is still inside the wound, whether the redness is moving, and whether the tetanus cover needs a top-up. Home care can support that visit; it cannot replace it.

Home care is here to support the visit, and it matters for what the clinician sees when you arrive. Here is the whole thing in the order you need it.

Why today and not "after the weekend"

• The hand is one of the areas clinicians treat as higher risk, because the tendons, joints and bones sit close under the skin.
• A puncture can push dirt, rust or a tiny fragment into a closed space, and that keeps going even when the outside looks calm.
• Red streaks that travel up the arm mean it has moved beyond the wound itself.
• Waiting at home to "see if it looks worse" is exactly the mistake to avoid here. If you are not sure whether the redness is spreading, treat it as spreading and go.

1. What you have tried, and what actually helps

The cleaning and dressing routine (this is the part that helps):

1. Rinse: clean running tap water over the wound for 2–3 minutes, only while you can still see dirt in it. No scrubbing. Do not poke it with anything, do not dig for a splinter. Do not add salt, bleach, iodine, alcohol, vinegar or "medicated" soap to the water.
2. Dry: pat with clean gauze or a clean cotton cloth. Do not rub.
3. Cover: clean gauze, tape on the surrounding skin — not sealed tight over a wet wound. Change it if it gets wet or dirty, and once before bed.
4. Raise: rest the hand on a pillow so it sits above heart level when you are sitting down. Gently straighten and bend the fingers a few times each hour while they are awake.
5. Protect: no cooking with that hand, no lifting, no soaking in water again, no housework with it. Whoever helps washes their hands before and after touching it.
6. Medicines: only what this person already takes safely, following the label or their prescriber — nothing new, no extra dose, and no stacking two products with the same ingredient. If they have diabetes, poor circulation, or take anything that lowers their immunity, say so at the clinic.

2. Limits and the avoid list

• No more soaking — hot water, salt water, or "medicated" soak.
• No powders or kitchen remedies: mustard powder, turmeric, toothpaste, oil, honey, ash, salt straight on the wound.
• No leftover, borrowed, or internet-bought antibiotics, creams, ointments or steroid creams.
• Do not squeeze, lance, probe or peel the skin to "check for pus". Do not pick the scab.
• Do not reuse the same bowl or water for the hand and for food preparation.
• Do not give the wound any medicine that was prescribed for someone else in the house, and do not change or stop anyone's regular medicine because of this.
• Keep the wound covered and out of reach of the child; wash hands before and after any contact.
• Do not plan the visit around "it might be nothing" — one week is long enough for a puncture.

3. Tonight / today: 25 minutes, three blocks

Block 1 — 5 minutes: mark and photograph.
Draw a thin pen line just outside the edge of the redness and write the time next to it. Take two photos: one wide (whole hand, the line, and a coin or ruler for scale) and one close-up. Those two photos plus the marked line are the cheapest way for tomorrow's clinician to see change — and they cost you five minutes.

Block 2 — 10 minutes: rinse, dress, raise.
Do the routine in section 1, then put the clinic list from section 5 on the fridge so it is ready to grab.

Block 3 — 10 minutes: sort the clinic and the family day.

• Find today's door: a same-day outpatient clinic, an urgent-care service, or the emergency department if any red flag in section 4 applies. Call ahead or walk in. Use these words so you are triaged faster: *"hand puncture wound, one week old, redness around it, possible red streaks, need a tetanus check."*
• Name one person for each job: who takes the child to school tomorrow, who stays with the other person in the house, who goes with you to the clinic if you cannot carry the child yourself.
• Write the clinic details and the time you marked the line on the fridge.

A message you can copy to whoever is covering:

> Quick heads-up: I am taking the hand puncture to a clinic today (it is a week old and needs checking). Could you do one thing: [exact task, day, time]? If I am not back by [time], [name] has the handover.

4. Decision tree

First, right now: does the person look unwell?
Fever or shaking chills, unusual sleepiness, confusion, fast breathing, faintness, refusing food or drink, or the whole hand swelling quickly.

• Yes → call your local emergency number now, or go to the nearest emergency department now. Say the words *"possible hand infection"*. Do not wait for tomorrow and do not wait for a callback.
• No → keep reading.

Then: any of these?

• Pain much worse than the redness looks.
• The redness spreading fast over hours, skin turning dark or blistering, or crackling under the skin.
• Fever or chills together with a hot, swollen, throbbing hand.
• The whole hand swelling rapidly, a finger becoming stiff or very painful to move, or swelling running along a finger tendon.
• Fingertips numb, pale, blue or cold.
• Foul-smelling pus, or the wound gaping open.

→ Emergency now: call your local emergency number, or go to the nearest emergency department. This is not a home-observation situation.

Otherwise, any of these?

• The redness has gone past your pen line or is clearly larger.
• A red streak is starting from the wound toward the elbow or armpit — even if they feel completely fine.
• Pus, yellow crust, increasing throbbing, or the wound simply is not healing.
• The puncture was a nail, thorn, glass, fish bone, rust or soil, or it was a bite — or you do not know when their last tetanus shot was.

→ Same-day clinic, today, in the hours that are left. Streaks mean today, not Monday. Do not use "let us see how it looks tomorrow" for a streak.

Otherwise: mild local redness that is not spreading, no fever, and they feel well — still go today, because the wound is a week old and the tetanus question and any retained fragment need eyes on it. Home steps in section 1 are support only.

5. Which follow-up matters

1. The visit today is the follow-up that matters. Nothing you do at home replaces it.
2. What the clinician decides there: whether the wound needs cleaning or opening up, whether something left inside has to come out, whether an antibiotic is needed and which one, and whether a tetanus booster is due. Bring the date of the last tetanus shot if you know it, and say what caused the puncture.
3. Before you leave, ask three things: *"What should bring us straight back?"*, *"Over what time should this be improving?"*, and *"What must we not do at home?"*
4. After today: watch the signs in section 4 for the next couple of days, keep dressings clean and dry, and do not stop any prescribed medicine on your own because it looks better. If a new sign appears, that is a return visit, not a home decision.
5. Tell the clinician if the person has diabetes, poor circulation, a weakened immune system, or takes regular medicines — it changes how quickly this is treated.

6. Bring to the visit

• The two photos, and the marked line with its time.
• What caused the puncture, and whether it was dirty, rusty, soil or a bite.
• The date of the last tetanus shot, or "I do not know".
• All medicines this person takes, plus allergies.
• Any other conditions: diabetes, circulation, immune.
• One sentence to say out loud: *"The wound was punctured on [date], one week ago. Redness started on [date]. Today it is [not spreading / past the line / has a streak]. We have not started any medicine."*

7. Success in 24 hours — signals to watch, not a promise of cure

• The clinic visit happened today and you know the next step they wrote down.
• 24 hours on, the redness edge has not moved past the pen line.
• No new streak, no fever, the hand is not more swollen, the fingers still move and feel normal.
• No pus, no bad smell, the dressing stayed clean and dry.
• The home routine ran: rinsed, dressed, raised, no soaking, no mystery creams.
• The week still holds: school run and the other person's care each have a named person today.

One question that changes what I can give you next: which city or country are you in? I can point you to the exact same-day clinic and urgent-care door and the official way to reach it — the emergency line and the walk-in rules differ by place.

And the honest limits: I cannot diagnose this from a message, and I cannot see the wound, so I cannot tell you whether there is infection, what is inside it, or whether the tetanus cover is current — that is what the visit is for. The steps above are support around that visit, not a treatment, and I am not a physician, so I do not choose medicines or doses for you here.

One more honest note: which doors and which emergency line are covered where you live is not something I can confirm without your city or country, so for that part there is no coverage I can hand you yet — tell me and I will look it up properly.