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 (such as penicillin, amoxicillin–clavulanate or metronidazole) can prevent other bacterial infections.

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. 

Page history

Last updated: 
4 June 2018
Last reviewed: 
4 June 2018