How to treat tetanus?

Written by Ai Bing Quan
General Surgery
Updated on December 05, 2024
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Generally speaking, a tetanus shot needs to be administered intramuscularly, but a skin test must be conducted before injection because tetanus vaccines can easily cause allergic reactions. The skin test usually involves a subcutaneous injection on the palm side of the forearm, followed by an observation period of 15 to 20 minutes. If there is no redness or itching, and the skin test is negative, then the vaccine can be administered intramuscularly, usually in the buttock. However, if the skin test is positive, as indicated by symptoms like redness, significant itching, or even systemic symptoms such as dizziness and cold sweats, it shows that the skin test for tetanus is positive. In this case, one can opt for a desensitization injection of diluted tetanus vaccine, followed by intramuscular injections four times, once every half hour, needing about two hours to complete.

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Written by Zhang Peng
General Surgery
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When is the best time to get a tetanus shot?

Tetanus infection carries a certain mortality rate, with current statistics indicating that the death rate from tetanus infection can reach around 40%. Typically, tetanus is caused by an acute, specific infection resulting from the growth and reproduction of Clostridium tetani in human wounds, which produce toxins. Generally, it can only grow and reproduce in an anoxic environment, so it is most commonly found in soil, human and animal feces, and rust. For wounds, especially sharp and deep cuts, it is usually vital to administer a tetanus shot promptly. The choices generally are tetanus immunoglobulin or tetanus antitoxin, which have different half-lives; tetanus antitoxin generally lasts about three days, whereas tetanus immunoglobulin can last up to three weeks. Therefore, in the presence of high-risk infection factors, it is advisable to administer the injection as soon as possible, generally recommended within 24 hours.

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Written by Liu Huan Huan
General Surgery
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How is tetanus diagnosed?

The diagnosis of tetanus requires comprehensive consideration. If the patient has a history of trauma with skin or mucosal wounds, and shows signs of muscle spasms, such as difficulty opening the mouth, stiffening of the neck, and increased reflexes, the possibility of a tetanus infection should be considered. Further, a culture of the wound can be conducted to see if Clostridium tetani can be cultured. If the culture is positive, a definitive diagnosis can be made. Additionally, tetanus needs to be differentiated from other diseases such as purulent meningitis, rabies, epilepsy, hysteria, and so on.

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Written by Tang Da Wei
General Surgery
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How deep is a tetanus wound?

There is no clear boundary concerning how deep a wound needs to be to carry a risk of tetanus; mainly, it depends on whether the conditions allow for anaerobic bacteria to thrive. Particularly, wounds that are very small on the surface but deep can lead to substantial proliferation of tetanus bacilli. A common example is a foot wound caused by stepping on a nail, where the exterior opening of the wound is small, but it is deep inside, and the nail surface may be rusty and also carry a large amount of tetanus bacilli. If the wound is not promptly and thoroughly cleaned, it can lead to massive growth of tetanus bacilli, resulting in the onset of severe illness in the patient.

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Written by Zhang Da Wei
General Surgery
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tetanus incidence rate

Tetanus is caused by the invasion of tetanus bacillus into the body through skin and mucous membranes. It generally grows faster in an anaerobic environment, causing specific changes in muscles, and in severe cases, can lead to body spasms and other issues. It usually invades nerves, leading to nerve damage. The incidence rate depends on the patient's health status. If the patient's immunity is low, the incidence rate can reach over 90%, and more than 90% of patients will show symptoms within two weeks of injury, potentially retaining some infectious issues. Therefore, timely handling of tetanus bacillus infections is necessary to achieve the best preventive effects. The incubation period for tetanus is usually about one week.

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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.