When should tetanus be given?

In the course of one's life, one will always suffer injuries of varying sizes. Some injuries are not very serious and will heal on their own without any care. However, some injuries are more serious. For example, being pricked by rusty objects can easily cause bacterial or viral infections. In this case, you have to take care of it and need to get a tetanus shot. So not all injuries require tetanus. Today I will give you a detailed introduction to the situations in which tetanus is needed.

Tetanus is a specific infection in which Clostridium tetani invades the human body through skin or mucous membrane wounds, grows and multiplies in an oxygen-deficient environment, produces toxins, and causes paroxysmal muscle spasms. There are no relevant guidelines for the prevention and treatment of tetanus in our country. Below, the editor will discuss the prevention of this disease with everyone based on relevant literature. Tetanus bacteria are commonly found in our daily life. They can be found in dust, soil, rust, and human or animal feces. They are mainly transmitted through skin or mucous membrane wounds, the most common of which are trauma and burns. In addition, cases of newborns born in unclean places and inadequate disinfection of surgical instruments are relatively rare. For wounds that are severe, small, or deep, an anaerobic environment is easily formed, which is conducive to the growth and reproduction of Bacillus. Tetanus bacteria are anaerobic bacteria that can easily grow and multiply in anaerobic conditions or when the wound is deep and infected with aerobic bacteria (anaerobic bacteria can easily multiply after aerobic bacteria consume oxygen).

1. When the wound is deep enough to require stitches, or when there are some serious external injuries, such as punctures or wounds from sharp objects such as nails, wood, and thorns, causing bleeding, such wounds are deep and thin, which are the breeding ground for tetanus bacteria.

2. Having an open wound or trauma does not necessarily lead to tetanus, because Clostridium difficile is an anaerobic bacterium that cannot reproduce and produce toxins in all wounds. Its infection requires certain conditions.

3. The external opening of the wound is small, and there is necrotic tissue, blood clots or excessive packing, local ischemia, etc. inside the wound, which creates an oxygen-deficient environment suitable for the growth and reproduction of tetanus bacteria. If aerobic infection is present, the latter will consume the remaining oxygen in the wound, making tetanus more likely to occur.

4. It can be seen that tetanus infection does not usually occur in superficial wounds. For simple surface abrasions, there is no need to get a tetanus shot for prevention after timely debridement; if the wound is deeper and more seriously contaminated, the possibility of tetanus will greatly increase, and a tetanus shot will be necessary.

Misunderstandings to avoid when taking tetanus shots

Myth 1: Injection is only effective within 24 hours after trauma

Most medical staff will tell patients that they should try to use tetanus antitoxin and tetanus immunoglobulin within 24 hours after the injury, otherwise the effect will be poor.

The incubation period of tetanus infection is usually 1 to 2 weeks. According to its pathogenesis, tetanus antitoxin can play a preventive role if applied within 24 hours after injury or even later. Clinically, emphasis should be placed on early application, but as long as the disease has not yet occurred and it is used within 2 weeks, it should be considered to have a preventive effect.

Myth 2: If you get a tetanus shot, you won’t get tetanus again

The antibodies brought to the body by passive immunization can only last for 2 to 3 weeks, after which the antibody levels drop and the body is no longer protected. Therefore, a single dose of tetanus antitoxin or tetanus immunoglobulin does not provide lasting immunity. Lasting immunity depends on active immunity produced in the body by tetanus toxoid vaccination.

These are all wrong

1. If there is a wound due to trauma, tetanus antitoxin (TAT) or tetanus immunoglobulin (TIG) should be injected as a routine. wrong!

2. The injection must be given within 24 hours after the trauma. There is no need to inject after 24 hours. wrong!

3. As long as you get the TAT or TIG injection in time, you will not get tetanus. wrong!

4. TAT, like tetanus toxoid (TT), has the functions of active immunization and primary prevention. wrong!

5. Non-traumatic injuries such as perianal abscess, colon perforation, and foreign bodies in the body do not require injection. wrong!