Small wounds can cause big trouble! In what situations do you need a tetanus shot?

The International Federation of Red Cross and Red Crescent Societies designates the second Saturday of September each year as "World First Aid Day" to popularize emergency first aid knowledge and skills, publicize and promote emergency first aid work, and call on countries around the world to pay attention to the popularization of first aid knowledge and let more people master first aid skills. September 9, 2023 is the 24th "World First Aid Day" with the theme of "Digital empowerment rescue at your side" (First Aid in the Digital World). The Emergency Department of Shanghai Sixth People's Hospital brings you popular science content-"Small wounds may cause big troubles."

According to statistics from the World Health Organization, about 1 million people die from tetanus every year in the world. In my country, the number of deaths from tetanus exceeds 10,000 per year, which poses a great threat to human health. Can you imagine that a disease with such a high mortality rate may be caused by just a small wound? Today's article will take you closer to the "tetanus"

What is tetanus?

Tetanus is a specific infection caused by Clostridium tetani invading the human body through skin or mucosal wounds, growing and multiplying in an anaerobic environment, and secreting neurotoxins. Clostridium tetani is an anaerobic bacterium that will feel pain and go dormant when there is oxygen around. It is widely present in nature in the form of spores, such as soil, air, water, and various objects. It can survive in the soil for decades and has strong adaptability to the environment. When an anaerobic environment is formed, Clostridium tetani will wake up from dormancy, multiply rapidly in large numbers, and secrete tetanus spasm toxin that reaches the central nervous system through the blood and causes disease. Its incubation period is generally about 10 days, but it can also occur within 24 hours, months, or even years after injury. Generally, the shorter the incubation period, the worse the prognosis.

Tetanus bacteria and their toxins cannot invade normal skin and mucous membranes, so tetanus often occurs after an injury. All open injuries are likely to cause tetanus. In clinical practice, some tetanus patients have no obvious inflammation or infection on the surface of their infected wounds, and some even appear to have healed. This leads many people to mistakenly believe that they have only suffered a "minor injury" and delay the best treatment time.

Once tetanus causes severe muscle spasms, it can cause muscle rupture or even fractures. The most serious result is death!

There are three necessary conditions for tetanus infection:

First, the object causing the wound is contaminated with tetanus bacteria;

Second, the injured body's resistance is reduced;

Third, the wound opening is small and deep, creating an anaerobic environment.

At present, the understanding of tetanus is that prevention is better than cure, and it is a terrible but preventable disease.

In what situations is tetanus vaccine needed?

People often have wounds of varying sizes in their daily lives, ranging from toothpick punctures to surgical wounds. Do we need tetanus shots for all of them? Actually, not necessarily.

According to the World Health Organization, the following types of wounds are at higher risk of tetanus and should be vaccinated according to the tetanus prevention schedule:

1. Including burns, scalds, frostbite, etc., which require surgical treatment but have not been treated for more than 6 hours

2. Including burns, scalds, frostbite, foreign matter or a lot of necrotic tissue in the wound, especially contaminated by dust, human and animal feces or saliva (animal bites)

3. Deep puncture wounds (such as nails, fish hooks, etc.)

4. Bullet or shrapnel, metal scratches

5. Open fractures and crush injuries

6. Trauma with sepsis symptoms such as hypotension

The sooner the tetanus vaccine is administered, the better; the best time is within 24 hours of injury.

What should I pay attention to after getting a tetanus vaccine?

1. Stay in hospital for half an hour for observation

Tetanus antitoxin can easily cause allergic reactions, so you should stay in the hospital for observation for at least 30 minutes after the injection of tetanus antitoxin to prevent allergic reactions and facilitate timely treatment; you can leave the hospital only after half an hour if there is no abnormality.

2. Low-grade fever

A mild fever may occur after vaccination. This is normal and there is no need to worry. You can do appropriate physical cooling and use antipyretics if necessary.

3. Eat a light diet and get adequate rest

Pay attention to your diet and avoid spicy and irritating food within a week. Try not to eat or eat less seafood, beef, mutton, etc., and avoid smoking, drinking alcohol, and drinking coffee. Maintain a regular work and rest schedule and do not overwork.

4. Keep the wound clean

After getting a tetanus shot, you still need to keep the wound clean to prevent infection, prevent the wound from coming into contact with water, and prevent it from being contaminated. If the wound is large and seriously contaminated, you should get another shot a week later to enhance the effect.

Kind tips:

It does not mean that you will be immune for life after one injection. If a new trauma occurs within a short period of time after the tetanus shot, you still need to get another tetanus shot. When a wound appears in life, no matter how big it is, it must be treated in time, especially for deeper wounds. Even if it is small, it is recommended to go to the hospital for treatment. If necessary, a tetanus injection is required. Such small wounds must be taken seriously, and timely medical treatment is the key!

The pictures are taken from the Internet. If there is any infringement, please let us know and they will be deleted.

Author: Guan Juan and Zhu Xiaoyan, the Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine