Stephen J. Schueler, M.D.

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Wound Puncture Tetanus

Most children born in the US have received three tetanus shots (boosters) in the past, because these boosters are part of the usual vaccination schedule. Additional tetanus boosters are given every 10 years.

Those who require treatment to prevent tetanus include:

Dirty wounds include:
  • Wounds that occur outdoors
  • Wounds that contain dirt or foreign material
  • Wounds caused by bites

Treatment Options

Tetanus Vaccine and TIG Recommendations
HistoryClean, Minor WoundOther Wounds
< 3 boostersgive Tdgive Td + TIG
3 boosterspossible Tdpossible Td

Clean and minor wounds may need a booster if it has been more than 10 years since the last tetanus vaccine. Other wounds may need a booster if it has been more than 5 years since last tetanus vaccine.

Continue to Wound Puncture Home Care

Last Updated: Nov 8, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Wound Puncture References
  1. Baldwin G, Colbourne M. Puncture wounds. Pediatr Rev. 1999 Jan;20(1):21-3. [9919048]
  2. Harrison M, Thomas M. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Antibiotics after puncture wounds to the foot. Emerg Med J. 2002 Jan;19(1):49. [11777876]
  3. Haverstock BD, Grossman JP. Puncture wounds of the foot. Evaluation and treatment. Clin Podiatr Med Surg. 1999 Oct;16(4):583-96. [10553222]
  4. Laughlin TJ, Armstrong DG, Caporusso J, Lavery LA. Soft tissue and bone infections from puncture wounds in children. West J Med. 1997 Feb;166(2):126-8. [9109329]
  5. Lavery LA, Walker SC, Harkless LB, Felder-Johnson K. Infected puncture wounds in diabetic and nondiabetic adults. Diabetes Care. 1995 Dec;18(12):1588-91. [8722056]
  6. Weber EJ. Plantar puncture wounds: a survey to determine the incidence of infection. J Accid Emerg Med. 1996 Jul;13(4):274-7. [8832349]
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