Can superficial wounds get tetanus?

Written by Liu Huan Huan
General Surgery
Updated on February 23, 2025
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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 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 Xu Jun Hui
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What is tetanus?

Tetanus infection occurs when Clostridium tetani invades the human body through skin and mucosal membranes, producing certain neurotoxins that lead to symptoms. As Clostridium tetani is an anaerobic bacterium, it typically thrives in anaerobic environments and is often found in heavily contaminated, muddy, or rusty conditions. Therefore, if there is an infection in a wound that is deep, located in an oxygen-poor environment, or heavily contaminated with dirt or rust, or in cases of extensive open fractures, explosion injuries, etc., anti-tetanus treatment is essential. It is generally recommended to administer an injection within 24 hours of the injury, which includes tetanus toxoid that requires a skin test—this is not to be used by patients with allergies—and tetanus immunoglobulin, which does not require a skin test.

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Written by Xing Wen Jun
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Cut by scissors on the hand requires a tetanus shot.

If the patient's hands were cut by scissors, first check if the scissors were rusty. If the scissors are rusty and the wound is small and deep, there's a higher risk of tetanus infection. It is advised that the patient should first rinse the wound under running water with soap repeatedly, then use hydrogen peroxide for local rinsing and scrubbing, followed by applying sterile iodophor for disinfection, and then cover with sterile dressing. It is recommended that the patient receive an injection of tetanus antitoxin within 24 hours for proactive prevention. If the scissors were made of stainless steel and relatively clean, and the wound is shallow, local treatment may suffice, and tetanus antitoxin injection generally isn't necessary. Additionally, during recovery, the patient should change dressings timely to prevent infection or the possibility of the wound splitting. If necessary, after cleaning and disinfecting, active suturing treatment should be considered.

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Written by Zhang Peng
General Surgery
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How many times do you need to get a tetanus shot?

The number of tetanus shots required depends on the specific condition of the wound and the patient's previous immunization history. Generally, for smaller, superficial, and cleaner wounds, which are considered to have a low risk of tetanus infection, the body can produce protective antibodies on its own. In such cases, a tetanus toxoid injection is given once a month, usually three times in total, allowing the patient's body to produce active antibodies and obtain long-term protection. If the wound is large, deep, and contaminated, with a substantial amount of foreign material or necrotic tissue, the chances of tetanus infection are very high. In such cases, passive immunization is actively conducted, usually involving tetanus antitoxin or immunoglobulin. Here, typically three doses of tetanus toxoid are administered to stimulate the body to produce active antibodies and achieve long-term protection.

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How long does it take for tetanus to develop?

Tetanus is an acute, specific infection caused by the invasion of Clostridium tetani into a human wound, where it grows and reproduces, producing toxins. Tetanus is a Gram-positive, anaerobic, spore-forming bacillus that is widely present in the external environment. Tetanus occurs only when tetanus bacillus grows and reproduces locally in a wound and produces exotoxins, which are the cause of the disease. The toxins of tetanus include spasm toxin and hemolysin. The incubation period of tetanus generally ranges from six to ten days. In some cases, it can occur within 24 hours or take as long as 20 to 30 days, or even months, particularly following the removal of foreign bodies or shrapnel. Neonatal tetanus generally occurs seven days after umbilical cord separation, clinically also known as the "seven-day wind." Generally, the shorter the duration of the incubation period or prodromal symptoms, the more severe the symptoms and the higher the mortality rate.