Identify whether the wound is tetanus-prone

Any wound other than a clean, minor cut is ‘tetanus-prone’. Tetanus may occur after a seemingly trivial injury, such as from a rose thorn. It is also possible to have no obvious signs of injury.

Certain types of injuries can favour the growth of Clostridium tetani, including:⁴

• compound fractures (fractures associated with a break in the skin)
• bite wounds
• deep, penetrating wounds
• wounds that contain foreign bodies (especially wood splinters)
• wounds that are complicated by pyogenic infections
• wounds with extensive tissue damage (for example, contusions or burns)
• any superficial wound that is obviously contaminated with soil, dust or horse manure (especially if topical disinfection is delayed more than 4 hours)
• reimplantation of an avulsed tooth, because the tooth undergoes minimal washing and cleaning to increase the likelihood of successful reimplantation
• depot injections, either subcutaneous or intradermal, in people who inject drugs

Antibiotics do not prevent or treat tetanus. However, antibiotics may be appropriate to treat other bacterial contaminants.

All tetanus-prone wounds must be disinfected and, where appropriate, have surgical treatment. Do this even if the person has up-to-date tetanus vaccinations.