Tetanus Risks and Wound Care After Injury

Questions about tetanus infection?

Hello, Doctor.
Last night, while returning home from my parents' house, I was hit on my hands and feet by the main entrance door (made of iron, unsure about the rust condition).
It was quite dark at the time, so I didn't see the wounds, only felt pain.
After returning home and taking a shower, I discovered two small wounds on the joint of my index finger, which were bleeding slightly.
I later used hydrogen peroxide (which expired two years ago) to disinfect the wounds.
It has been over 10 years since my last tetanus vaccine.
Please refer to the attached images for the wound condition: — https://ibb.co/hLT5tyT (after shower last night) — https://ibb.co/YLV9cBk (dry condition this morning, front view) — https://ibb.co/r0QdqhK (dry condition this morning, side view).
I have already reviewed the doctor's responses to similar issues, but I still have some questions:
1.
My condition should be considered a superficial wound, so theoretically, I shouldn't need a tetanus vaccine, right?
2.
The doctor mentioned in other responses that infection is not significantly related to rust, so is the idea that injuries from rusted iron lead to tetanus just a myth?
3.
There are sources online stating that the incubation period for tetanus can be as long as several years.
Is this true? What should I observe next to confirm there is no infection?
4.
Is expired hydrogen peroxide still effective for use? What do you recommend for further wound care?
5.
Once the wound has healed, should I no longer worry about the risk of tetanus infection?
I have friends and relatives who suffered from tetanus due to injuries from iron nails decades ago, so I am quite concerned.
I would greatly appreciate your help in answering these questions.
Thank you very much.

Y, 20~29 year old female. Ask Date: 2021/07/26

Dr. Ke Fangxu reply Surgery

1.
Yes
2.
Yes
3.
The incubation period is generally considered to be 3-21 days.

4.
The antibacterial efficacy of hydrogen peroxide does decrease after its expiration date; however, your wound no longer requires special treatment.

5.
Yes

Reply Date: 2021/07/26

More Info

Hello! Thank you for reaching out with your concerns regarding your recent injury and the potential risks associated with tetanus. I understand that you are feeling anxious about the situation, especially given the history of tetanus infections you mentioned. Let’s address your questions one by one.

1. Should you receive a tetanus shot?
Generally, if your last tetanus booster was more than 10 years ago and you have a wound that is more than a simple scrape, it is advisable to get a booster shot. Since you mentioned that your injury was caused by a metal door and you have two small cuts, it would be prudent to consult a healthcare provider about receiving a tetanus booster. Even though the wounds appear superficial, it’s better to err on the side of caution, especially considering the potential for tetanus.

2. Is the belief that rust is linked to tetanus a myth?
The idea that rust itself causes tetanus is indeed a misconception. Tetanus is caused by the bacterium *Clostridium tetani*, which can be found in soil, dust, and animal feces, not just rust. While rusty objects can be associated with deeper puncture wounds that may harbor the bacteria, it is not the rust that causes the infection. The risk of tetanus is more about the nature of the wound and the bacteria present rather than the rust itself.

3. Is it true that the incubation period for tetanus can be several years?
Yes, it is true that the incubation period for tetanus can vary widely, typically ranging from 7 to 21 days, but in rare cases, it can extend to several months or even years. This variability is why it is essential to stay up to date with your vaccinations, especially if you sustain injuries that could expose you to the bacteria.

4. What to do about expired hydrogen peroxide?
Using expired hydrogen peroxide may not be effective, as its potency diminishes over time. It is better to use a fresh antiseptic solution. For wound care, you should clean the area gently with soap and water, as this is the most effective way to reduce the risk of infection. After cleaning, you can apply a topical antibiotic ointment and cover the wound with a sterile bandage.

5. Do you need to worry about tetanus after the wound heals?
Once your wound has healed and you have received appropriate care, the immediate risk of tetanus decreases significantly. However, it is crucial to maintain your vaccination schedule. If you have any signs of infection, such as increased redness, swelling, warmth, or pus, or if you experience muscle stiffness or spasms, seek medical attention immediately.

In summary, I recommend that you consult a healthcare professional regarding your tetanus vaccination status and the need for a booster. Proper wound care is essential, so ensure you clean the wound adequately and monitor it for any signs of infection. If you have any further concerns or if the wound does not improve, do not hesitate to seek medical advice. Your health and safety are paramount, and it’s always better to be cautious when it comes to potential infections. Thank you for your questions, and I hope you have a smooth recovery!

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