What will happen with tetanus?

Written by Ai Bing Quan
General Surgery
Updated on March 20, 2025
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In clinical settings, tetanus is a type of surgical-specific infectious disease caused by the infiltration of Clostridium tetani through human skin, mucous membranes, or wounds. Tetanus toxin is a true anaerobic bacterium that thrives in oxygen-deprived environments and is highly resistant to environmental conditions. Clostridium tetani mainly produces tetanus toxin and tetanolysin, which can cause whole-body muscle spasms, including facial muscle spasms and difficulty opening the mouth. It can also lead to persistent spasms of the respiratory muscles and diaphragm, causing respiratory arrest and, in severe cases, can result in patient death.

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Written by Liu Huan Huan
General Surgery
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Will a scrape lead to tetanus?

When a tetanus infection occurs, the wound is generally quite deep, for instance, reaching the subcutaneous fat or even the muscle layer in severe cases. Such deep wounds can create an anaerobic environment, which is conducive for the growth and reproduction of Clostridium tetani, an anaerobic bacterium. This bacterium produces exotoxins, primarily the tetanospasmin, which causes the associated clinical symptoms in patients. If it's merely a scrape or a superficial wound, tetanus infection is unlikely. Clinically, what is needed for such abrasions is to disinfect the area with iodine and then bandage it appropriately.

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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.

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Written by Zhang Peng
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How deep does a wound have to be to cause tetanus?

There is no specific rule about how deep a wound needs to be to develop tetanus. Generally, any relatively contaminated wound that is sharp and deep should receive a prompt tetanus injection, as tetanus is a strictly anaerobic bacterium. Generally, if a wound is particularly prone to forming a locally hypoxic environment, active immunization should be pursued. Usually, the following types of wounds should be given high attention: deep puncture wounds, bullet or shrapnel injuries, open fractures, or crush injuries. Burns, frostbites that require surgical intervention, and wounds that have not been treated in a timely manner after more than six hours should also be taken seriously. Attention should be heightened if there are foreign objects in the wound or a significant amount of necrotic tissue, especially if contaminated by surrounding dust or animal feces.

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Written by Liu Huan Huan
General Surgery
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Is tetanus administered intramuscularly or subcutaneously?

Tetanus is widely used clinically and is known as tetanus antitoxin, intended solely to prevent the clinical symptoms caused by infection with Clostridium tetani. Therefore, a skin test must be conducted before administering tetanus injections. The common skin test involves creating a skin wheal intradermally; if the skin test is negative, one can proceed with the tetanus antitoxin injection. The injection can be administered intramuscularly or subcutaneously. For example, the common sites include the deltoid attachment area on the upper arm for subcutaneous injections, and the deltoid or the lateral part of the buttock for intramuscular injections, among others. These are the injection sites for tetanus.

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Can a tetanus shot be administered again?

If a tetanus shot is administered within 24 to 48 hours after injury, it can effectively prevent tetanus. However, if the tetanus shot is given a week or more after the injury, the effectiveness and relevance of the booster are generally not ideal. In such cases, tetanus immunoglobulin can be used for comprehensive antibody therapy to treat and prevent tetanus. Therefore, when the body sustains external injuries or certain infectious foci, it is crucial to promptly administer a tetanus shot intramuscularly, ideally within 24 hours, to effectively stimulate the body to produce the corresponding antibodies for protection.