Table. Characteristics of tetanus-prone wounds
| Clinical features | Tetanus-prone wounds | Nontetanus-prone wounds |
|---|---|---|
| Age of wound | >6 hr | <=6 hr |
| Configuration | Stellate wound | Linear wound |
| Depth | >1 cm | <= 1 cm |
| Mechanism of injury | Missile, crush, burn, or frostbite | Sharp surface(e.g. knife) |
| Signs of infection | Present | Absent |
| Devitalized tissue | Present | Absent |
| Contaminants (dirt, feces, soil, saliva) | Present | Absent |
| Denervated or ischemic tissue, or both | Present | Absent |
Table. Summary guide to tetanus prophylaxis in routine wound management. (Centers for Disease Control and Prevention: ACIP recommendations: Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies, 2011[http://www.cdc.gov/rabies/resources/acip_recommendations.html]).
1 A primary series consists of a minimum of 3 doses of tetanus- and
diphtheria-containing vaccine (DTaP/DTP/Tdap/DT/Td).
2 Age-appropriate vaccine:
- DTaP for infants and children 6 weeks up to 7 years of age (or DT pediatric if pertussis vaccine is contraindicated);
- Tetanus-diphtheria (Td) toxoid for persons 7 through 9 years of age; and >= 65 years of age;
- Tdap for persons 10 through 64 years, unless the person has received a prior dose of Tdap.*
3 No vaccine or TIG is recommended for infants < 6 weeks of age with clean, minor wounds. (And no vaccine is licensed for infants < 6 weeks of age.)
4 Tdap is preferred for persons age 10 through 64 who have never received Tdap. Td is preferred to tetanus toxoid (TT) for persons 7 through 9 years, or >= 65 years, or those who have received a Tdap previously. If TT is administered, an adsorbed TT product is preferred to fluid TT. (All DTaP/DTP/Tdap/DT/Td products contain adsorbed tetanus toxoid.)
5 Give TIG 250 U IM for all ages. It can and should be given simultaneously with the tetanus-containing vaccine.
6 For infants < 6 weeks of age, TIG (without vaccine) is recommended for “dirty” wounds (wounds other than clean, minor).
7 Persons who are HIV positive should receive TIG regardless of tetanus immunization history.
备注：表格分别摘自RAYMOND J. FONSECA等主编的Oral and Maxillofacial Trauma, 4th edition, Page 509, 769.