What is the best treatment for puncture wound on arm?

Puncture Wound Rx. As with all puncture wounds, immediate treatment with aggressive cleansing and disinfecting is the key. Any external dirt, particles, or objects must be removed. If bleeding is controlled, then a clean gauze dressing, changed every 2 days is sufficient. Watch for signs of bacterial infection with redness, more swelling, and drainage usually on the 2nd or 3rd day. This requires antibiotics.