How do we review this?

It's technically a very slow Hero Response card, since it can only be applied to an enemy that was previously attacked this turn.

For my money, I treat this card as Honey Badger Special. If it looks like the villain may be a problem this turn, have her poke the villain and attach this card.

But if there is a serious minion threat, then that is a prime target for Puncture Wound.

The beauty is in the fact that you can make your decision later. So even if you are certain about which enemy you need to debuff, you can take your time deciding, since Puncture Wound's application only specifies an enemy that was attacked 'this turn'.

In a multi-hero game, this prevents you from wasting this card on an enemy that would be defeated that round. Excellent application of situational variance.