Puncture Wound of Soft Tissue
The second soft tissue injury that occurs with some frequency is inadvertent puncturing of the soft tissue. Instruments, such ‘as a straight elevator or periosteal elevator, may slip from the surgical field and puncture or tear into adjacent soft tissue. ‘. Once again, this injury is the result of using uncon-
.trolled force instead of finesse and is best prevented by the use of controlled force, with special attention given to the supporting fingers or support from the opposite hand in anticipation of slippage. If the instrument slips from the tooth or bone, the fingers thus catch the hand before injury occurs (Fig. 11-2). When a puncture wound does occur, the treatment is aimed primarily at preventing infection and allowing healing to occur, usually by secondary intention. If the wound bleeds excessively, it
should be controlled by direct pressure on the soft tissue. Once hemostasis is achieved, the wound is usually left open and not sutured, so that if a small infection were to occur, there would be an adequate pathway for drainage.