Remember how much fun it was to run barefooted, your feet brushing along the freshly cut grass? Remember also how your cosmic high was smashed to smithereens, as soon as your foot stepped on that rusty nail?

 Puncture w0unds are all too common. For the most part these wounds are relatively benign, but some caveats are in order.

Believe it or not, you are better off if you stepped on something without shoes rather than with shoes. Why? The object, which is often a nail, will carry a very small piece of the shoe’s sole with it on its way through your skin. It is that small, usually rubber section of the shoe which underneath your skin can cause some nasty problems. Bacteria like foreign bodies such as rubber. Certain ‘bad boy’ bacteria such as Pseudomonas seem to thrive on bits of rubber soles. These guys can wreak havoc, causing not only skin infections such as cellulitis and abscesses, but also bone infections.

Bone infections or osteomyelitis can occur when a nearby area such as the skin and soft tissue underneath is infected. The infection spreads to the bone, where it destroys the bone marrow and sometimes can cause death of parts of the bone. These bone infections are very difficult to treat, usually requiring weeks to months of antibiotic therapy. Sometimes surgery is required to clean out the bone.

Certain persons are more likely to have worse infections. Diabetics, due to lack of good blood supply, elevated blood sugar and poor nerve function have a greater risk of bad infections. So too do smokers, patients with malnutrition, cancer or poor blood supply to their feet. In some cases infections can lead to breakdown of the skin (skin ulcers) to the point where amputation of part or all of the foot is needed.

Another issue is tetanus. Rusty nails can carry tetanus. Although tetanus is very, very rare it is almost always fatal. A simple tetanus booster every five years for clean wounds or every ten years for dirty ones, is all that is needed. (Unless of course you have never been immunized against tetanus. For those individuals an additional treatment would be necessary. Talk to your doctor.) Tetanus vaccine is often coupled with pertussis or whooping cough vaccine and is very safe.

If you do step on a nail, clean off the wound and call your doctor to see if you need antibiotics to prevent infection and if your tetanus immunizations are up to date.

Having a back to nature experience? Keep the shoes off, when you run through that meadow,because aux natural means no risk of rubber under your skin!

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