Tetanus Risks in Deep Wounds: What You Need to Know

Is the wound from a tetanus injury in an anaerobic state when sutured?

Hello, doctor.
I am 35 years old.
Today, I accidentally cut myself on a rusty paint can lid that had been in a chicken coop for many years.
The lid had irregular sharp edges, was very dirty, and had insect droppings on it.
The wound is long and deep, with significant tissue damage.
When I got home, I rinsed it with tap water and applied Betadine (that's all I had available).
It seemed like there was dirt inside, but I was afraid to clean it thoroughly due to the pain (the injury is located on the back of my hand, just below the little finger).
I then went to a small clinic in Yunlin for treatment.
I only vaguely described the situation to the doctor and did not clearly explain the condition at the time of the injury.
I wasn't sure if the doctor cleaned it properly; I was lying down and felt liquid being applied to the wound, but I was in too much pain to look.
I was concerned that the dirt inside was not visible due to the darker color of the Betadine, and I forgot to tell the doctor about the dirt.
The doctor said that I needed stitches, and so they stitched it up.

Now, I have a question: I heard that tetanus bacteria are anaerobic, so after stitching, will the wound be in an anaerobic state? I noticed on the receipt that I received a 0.5 ml tetanus toxoid vaccine.
I am really scared about the possibility of getting tetanus.
Thank you very much for your patient response.

Xiao Wei, 30~39 year old female. Ask Date: 2020/07/02

Dr. Ke Fangxu reply Surgery

The Clostridium tetani is an anaerobic bacterium that can only survive in an oxygen-free environment.
It is indeed possible to contract this infection from deeper wounds, which is why the physician administered the tetanus vaccine to prevent infection by Clostridium tetani.
As long as the wound is properly cleaned and sutured, there should be no risk of tetanus infection.
In Taiwan, there have not been any cases for quite some time.
In fact, you should be more concerned about the possibility of other bacterial infections that could lead to cellulitis.
It is recommended that you complete the prescribed medication and return for regular follow-up appointments to monitor the wound.

Reply Date: 2020/07/02

More Info

Tetanus is a serious bacterial infection caused by the bacterium Clostridium tetani, which is commonly found in soil, dust, and animal feces. It can enter the body through deep wounds, especially those that are contaminated with dirt, rust, or fecal matter. Given your situation, where you sustained a deep and dirty wound from a rusty object, it is understandable to be concerned about the risk of tetanus.

When a wound is deep and contaminated, it creates an environment that can be conducive to the growth of anaerobic bacteria, including Clostridium tetani. Anaerobic bacteria thrive in low-oxygen environments, which can occur in deep puncture wounds or lacerations that are not adequately cleaned. In your case, the fact that the wound was deep and had dirt and possibly fecal matter raises the risk of tetanus.

You mentioned that you received a tetanus toxoid vaccine (0.5ml) at the clinic. This is a crucial step in preventing tetanus. The tetanus toxoid vaccine helps your body build immunity against the toxin produced by the bacteria. If you have had a complete vaccination series in the past, a booster shot is typically recommended every ten years. However, if your last booster was more than five years ago and the wound is particularly dirty or deep, a booster may be given regardless of the last vaccination date.

It is also important to note that if the wound was not cleaned thoroughly, there could still be a risk of infection. The healthcare provider should have assessed the wound properly, and if there were any signs of infection or if the wound was not adequately cleaned, further treatment may be necessary. If you notice any signs of infection, such as increased redness, swelling, warmth, or discharge from the wound, or if you experience symptoms such as muscle stiffness or spasms, you should seek medical attention immediately.

In summary, while the risk of tetanus exists with deep and contaminated wounds, receiving the tetanus toxoid vaccine is a significant preventive measure. It is essential to monitor the wound for any signs of infection and to follow up with your healthcare provider if you have any concerns. If you have not had a complete vaccination series or if you are unsure about your vaccination history, it is advisable to discuss this with your doctor to ensure you are adequately protected against tetanus.

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