Tetanus and trauma

A review and recommendations

Peter M Rhee, Mary K. Nunley, Demetrios Demetriades, George Velmahos, Jay J. Doucet

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: This review covers the pathogenesis and treatment of the disease along with the reexamination of the current recommendations for prophylaxis against tetanus in the United States, Although tetanus is still a major problem worldwide, the incidence in North America has become almost negligible because of the highly effective primary immunization program. Recently, there have been no deaths reported attributable to tetanus in the United States in trauma patients who had received the primary childhood immunization. However, tetanus immunization and prophylaxis in the acute injury setting is frequently misused and misunderstood. Methods: A review of the literature regarding tetanus. Results: After review, the authors recommend tetanus toxoid in adults only if it has been more than 10 years since their last immunization. There is no urgency for the administration of tetanus toxoid in the acute setting, as it provides protection against the next injury and not the current injury. Tetanus-diphtheria toxoid is not required unless there are plans for the injured patient to travel to diphtheria-prone countries in the future, as the incidence of diphtheria is negligible in the United States. Conclusion: The review of reported cases of tetanus demonstrates that it is not possible to clinically determine which wounds are tetanus prone, as tetanus can occur after minor, seemingly innocuous injuries, yet is rare after severely contaminated wounds. Tetanus immunoglobulin should be reserved for patients with wounds who had never received primary immunization against tetanus.

Original languageEnglish (US)
Pages (from-to)1082-1088
Number of pages7
JournalJournal of Trauma
Volume58
Issue number5
DOIs
StatePublished - May 2005
Externally publishedYes

Fingerprint

Tetanus
Wounds and Injuries
Tetanus Toxoid
Immunization
Diphtheria
Diphtheria Toxoid
Immunization Programs
Incidence
North America
Immunoglobulins

Keywords

  • Guidelines
  • Immunizations
  • Immunoglobulins
  • Tetanus
  • Tetanus antitoxin
  • Tetanus toxoid
  • Vaccination
  • Wounds

ASJC Scopus subject areas

  • Surgery

Cite this

Rhee, P. M., Nunley, M. K., Demetriades, D., Velmahos, G., & Doucet, J. J. (2005). Tetanus and trauma: A review and recommendations. Journal of Trauma, 58(5), 1082-1088. https://doi.org/10.1097/01.TA.0000162148.03280.02

Tetanus and trauma : A review and recommendations. / Rhee, Peter M; Nunley, Mary K.; Demetriades, Demetrios; Velmahos, George; Doucet, Jay J.

In: Journal of Trauma, Vol. 58, No. 5, 05.2005, p. 1082-1088.

Research output: Contribution to journalArticle

Rhee, PM, Nunley, MK, Demetriades, D, Velmahos, G & Doucet, JJ 2005, 'Tetanus and trauma: A review and recommendations', Journal of Trauma, vol. 58, no. 5, pp. 1082-1088. https://doi.org/10.1097/01.TA.0000162148.03280.02
Rhee PM, Nunley MK, Demetriades D, Velmahos G, Doucet JJ. Tetanus and trauma: A review and recommendations. Journal of Trauma. 2005 May;58(5):1082-1088. https://doi.org/10.1097/01.TA.0000162148.03280.02
Rhee, Peter M ; Nunley, Mary K. ; Demetriades, Demetrios ; Velmahos, George ; Doucet, Jay J. / Tetanus and trauma : A review and recommendations. In: Journal of Trauma. 2005 ; Vol. 58, No. 5. pp. 1082-1088.
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