Tetanus

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Written by He Zong Quan
General Surgery
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Can a festering wound lead to tetanus?

Wound suppuration and contracting tetanus are two different concepts. Wound suppuration primarily occurs when there is an infection at the wound site, which spreads due to lack of significant control over the infection focus. We need to actively locate the infection source, perform thorough surgical debridement and drainage, use sensitive antibiotics as needed globally, and change dressings in a timely manner to manage the infection. Tetanus, on the other hand, is typically considered when the wound is too deep and visibly contaminated, often by rusty, sharp objects causing the infection. In such cases, thorough surgical cleansing of the wound is essential to prevent surface contamination, along with the systemic use of tetanus antitoxin to reduce or prevent a tetanus infection.

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Written by Zhang Peng
General Surgery
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How long can a tetanus shot last?

The duration of a tetanus shot can be considered from two different immunization processes. In the case of passive immunity, it typically lasts for a shorter duration. If tetanus antitoxin is administered, it generally lasts between two to four days, while tetanus immunoglobulin can last up to three weeks. After this period, the level of antibodies gradually decreases, and the body may no longer be protected. Therefore, a single use of tetanus antitoxin or immunoglobulin does not provide lasting immunity. The second method is what we commonly refer to as getting a tetanus vaccine, which is a process of active immunity. Usually, for active immunity, the tetanus bacterium is processed and made into a weakened vaccine for injection. Antibodies can be produced after about ten days, and within two to three months, the level of antibodies in the body gradually increases and remains at a high titer, providing immunity for up to about ten years.

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Written by Li Jin Quan
General Surgery
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Can tetanus be fatal?

Firstly, it must be acknowledged that if a patient with tetanus does not receive timely treatment, it can be fatal. When tetanus infection occurs, the early symptoms mainly include dizziness, headache, fatigue, loss of appetite, weak chewing, sore jaw muscles, or some heightened reflexes, or muscle tension. As tetanus worsens, it can manifest as typical clinical symptoms, mainly lockjaw, difficulty opening the mouth, sardonic smile, stiff neck, opisthotonos, and in severe cases, difficulty breathing, respiratory arrest, and even cardiac arrest. If emergency treatment is not administered promptly, the patient can die.

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Written by Li Xiao Lin
Emergency Department
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Will tetanus cause muscle soreness?

Tetanus can cause muscle pain. The main symptoms of a tetanus attack include sudden onset, impaired consciousness, frothing at the mouth, limb convulsions, body stiffness, presenting in an opisthotonos posture, and concurrent incontinence of urine and feces, with the duration varying according to the condition. Because convulsions cause the muscles to be in a state of rigidity, this leads to muscle ischemia and hypoxia, thereby increasing lactic acid and causing this state of muscle pain. Therefore, during a tetanus attack, measures should be taken to control these convulsions. At the same time, use chopsticks to prop against the teeth to prevent biting the tongue and other such incidents. If the condition is severe, immediately call emergency services (120) to get to a hospital for urgent treatment.

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Written by Xu Jun Hui
General Surgery
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Can I get a tetanus shot in the emergency room?

The injection of tetanus shots is performed in the emergency department of regular hospitals. Tetanus shots are divided into tetanus toxoid, which requires a skin test, and tetanus immunoglobulin, which does not require a skin test. If the skin test for tetanus toxoid is positive, indicating an allergy, it cannot be injected, and must be replaced with the slightly more expensive tetanus immunoglobulin. It is generally recommended to administer the injection within 24 hours after injury to prevent infection by Clostridium tetani. Clostridium tetani is an anaerobic bacterium. It is necessary to administer tetanus treatment for injuries that are deep, in anaerobic conditions, contaminated, heavily contaminated with soil, rust, open fractures, etc., since these conditions can be conducive to tetanus infection.

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Written by Liu Huan Huan
General Surgery
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Cut your finger, need a tetanus shot

The key is to assess the severity of the finger cut. If it's just a superficial skin scratch, then the wound is shallow, and it only requires disinfection with agents like iodophor or alcohol; there's no need for a tetanus shot. Conversely, if the cut on the finger is deep, such as reaching the subcutaneous fat or, in severe cases, the muscle layer, such deep wounds can easily lead to the growth and reproduction of tetanus bacillus, producing toxins and causing clinical symptoms in patients. Therefore, in such cases, it is recommended that patients go to the hospital to receive a tetanus antitoxin injection.

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Written by Li Chang Yue
General Surgery
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Does tetanus infect others?

Tetanus occurs when wounds are contaminated by Clostridium tetani, which then proliferates and grows within the human body, ultimately causing tetanus. Generally, tetanus is not transmitted from person to person; it usually occurs when bacteria invade the body through external injuries or wounds. Additionally, newborns may contract tetanus through the birth canal during delivery. Therefore, for deep or large wounds, especially in heavily contaminated conditions, it is crucial to clean and possibly stitch the wounds promptly. If necessary, tetanus immune globulin injections and vaccinations against these bacteria can be administered to thoroughly prevent the occurrence of tetanus.

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Written by Tang Da Wei
General Surgery
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When to get a tetanus shot

A tetanus shot is generally recommended to be administered immediately after an injury for the best efficacy. If given within 12 or 24 hours, it still provides certain preventive effects. The tetanus shot mainly consists of tetanus antitoxin and represents passive immunization. It is usually advised in cases of deep wounds with small surface areas that can create anaerobic conditions inside. If tetanus bacillus is present in the wound and proliferates massively under anaerobic conditions, the patient may exhibit symptoms such as opisthotonos, asphyxiation, or even death. Therefore, it is necessary to administer tetanus antitoxin for prevention.

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Written by Liu Huan Huan
General Surgery
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Can superficial wounds get tetanus?

Tetanus infection commonly occurs in deeper wounds, for instance, wounds that reach the subcutaneous fat layer, and in severe cases, even the muscle layer. Such deep wounds can create an anaerobic environment, and Clostridium tetani, an anaerobic bacterium, thrives in this oxygen-free environment. It can secrete various bacterial toxins, thereby causing tetanus in patients. Therefore, tetanus generally occurs in deep wounds. For superficial wounds, the chance of contracting tetanus is almost zero if the wound is properly disinfected locally.

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Written by Gao Jun
Emergency Surgery
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What should I do if the tetanus test is positive?

A positive tetanus result generally refers to a positive result in the tetanus antitoxin skin test. Tetanus antitoxin is primarily used to prevent tetanus infections. Some patients may experience allergic reactions to tetanus, manifesting as localized swelling, mild fever, and general discomfort during the skin test. In such cases, a desensitization injection method can be chosen, which involves administering the tetanus shot in several doses at intervals. Alternatively, tetanus immunoglobulin can be used, which is more expensive on the market but has the advantage of not requiring a skin test. It can be administered directly, safely, and effectively.