💉 Tetanus Prophylaxis (Wound Management)
This tool judges the need for tetanus vaccine and immune globulin (TIG) by wound type and immunization history.
Clinical takeaway
A clean minor wound never warrants TIG, whereas a contaminated wound in an under-immunized or immunocompromised patient does. (original synthesis · not guideline verbatim)
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When to use
Use during wound care to decide vaccine and TIG, accounting for contaminated wounds and immunocompromise.
How it works
Clean minor wound → vaccine only if history unknown/incomplete or > 10 yr; never TIG. Contaminated/larger wound → vaccine + TIG if history unknown/incomplete, vaccine booster if > 5 yr. HIV/severe immunodeficiency + dirty wound → TIG regardless.
Key points
- A clean minor wound never warrants TIG, whereas a contaminated wound in an under-immunized or immunocompromised patient does. (original synthesis · not guideline verbatim)
- TIG neutralizes only free toxin, so thorough wound debridement remains essential.
- Antibiotics do not substitute for immunoprophylaxis, and the primary series should be completed.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Wound type | Clean minor wound |
|---|---|
| Tetanus immunization history | Unknown or < 3 doses |
| HIV or severe immunodeficiency | No |
→DispositionGive vaccine
- Vaccine：Give a tetanus-toxoid-containing vaccine (Td/Tdap, 0.5 mL IM; prefer Tdap if never given Tdap, Tdap in pregnancy)
- TIG：No TIG needed (a clean minor wound never needs TIG)
- Wound care：Thorough debridement, irrigation, removal of devitalized tissue and foreign bodies; TIG only neutralizes free toxin, not toxin already bound to nerve endings, so give early when indicated
| Wound type | Contaminated or larger wound (puncture/soil-feces contamination/devitalized tissue/burn/crush/bite) |
|---|---|
| Tetanus immunization history | ≥ 3 doses and > 10 yr since last |
| HIV or severe immunodeficiency | Yes |
→DispositionGive vaccine + TIG
- Vaccine：Give a tetanus-toxoid-containing vaccine (Td/Tdap, 0.5 mL IM; prefer Tdap if never given Tdap, Tdap in pregnancy)
- TIG：Give tetanus immune globulin TIG 250 IU IM (different syringe and site from the vaccine)
- Wound care：Thorough debridement, irrigation, removal of devitalized tissue and foreign bodies; TIG only neutralizes free toxin, not toxin already bound to nerve endings, so give early when indicated
Frequently asked questions
- What is Tetanus Prophylaxis (Wound Management)?
- This tool judges the need for tetanus vaccine and immune globulin (TIG) by wound type and immunization history.
- How is Tetanus Prophylaxis (Wound Management) calculated? What is the core formula?
- Clean minor wound → vaccine only if history unknown/incomplete or > 10 yr; never TIG. Contaminated/larger wound → vaccine + TIG if history unknown/incomplete, vaccine booster if > 5 yr. HIV/severe immunodeficiency + dirty wound → TIG regardless.
- When is Tetanus Prophylaxis (Wound Management) used?
- Use during wound care to decide vaccine and TIG, accounting for contaminated wounds and immunocompromise.
- What are the key clinical points for Tetanus Prophylaxis (Wound Management)?
- A clean minor wound never warrants TIG, whereas a contaminated wound in an under-immunized or immunocompromised patient does. (original synthesis · not guideline verbatim) TIG neutralizes only free toxin, so thorough wound debridement remains essential. Antibiotics do not substitute for immunoprophylaxis, and the primary series should be completed.
- What are the limits and cautions when using Tetanus Prophylaxis (Wound Management)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Tetanus Prophylaxis (Wound Management) calculated in practice? Can you show a worked example?
- Inputs: Wound type Clean minor wound, Tetanus immunization history Unknown or < 3 doses, HIV or severe immunodeficiency No → Result: Disposition Give vaccine（Vaccine: Give a tetanus-toxoid-containing vaccine (Td/Tdap, 0.5 mL IM; prefer Tdap if never given Tdap, Tdap in pregnancy), TIG: No TIG needed (a clean minor wound never needs TIG), Wound care: Thorough debridement, irrigation, removal of devitalized tissue and foreign bodies; TIG only neutralizes free toxin, not toxin already bound to nerve endings, so give early when indicated） Inputs: Wound type Contaminated or larger wound (puncture/soil-feces contamination/devitalized tissue/burn/crush/bite), Tetanus immunization history ≥ 3 doses and > 10 yr since last, HIV or severe immunodeficiency Yes → Result: Disposition Give vaccine + TIG（Vaccine: Give a tetanus-toxoid-containing vaccine (Td/Tdap, 0.5 mL IM; prefer Tdap if never given Tdap, Tdap in pregnancy), TIG: Give tetanus immune globulin TIG 250 IU IM (different syringe and site from the vaccine), Wound care: Thorough debridement, irrigation, removal of devitalized tissue and foreign bodies; TIG only neutralizes free toxin, not toxin already bound to nerve endings, so give early when indicated）