Tetanus Prophylaxis in Routine Wound Management
History of Adsorbed Tetanus Toxoid | Clean, Minor Wounds | All Other Wounds* | ||
|---|---|---|---|---|
DTaP, Tdap, or Td† | TIG‡ | DTaP, Tdap, or Td† | TIG‡ | |
Unknown or < 3 doses | Yes | No | Yes | Yes |
≥ 3 doses | Yes if > 10 years since last dose | No | Yes if ≥ 5 years since last dose | No |
* Such as (but not limited to) wounds contaminated with dirt, feces, soil, or saliva; puncture wounds; crush injuries; avulsions; and wounds resulting from missiles, burns, or frostbite. | ||||
† DTaP is recommended for children < 7 years of age. For patients ≥ 11 years of age who have not previously received a dose of Tdap, a single dose of Tdap should be given. Patients ≥ 7 years of age who are not fully immunized against pertussis, tetanus, or diphtheria should receive one dose of Tdap for wound management and as part of the catch-up series. | ||||
‡ For adults, TIG 500 units IM once. People with HIV infection or severe immunodeficiency who have contaminated wounds (including minor wounds) should also receive TIG, regardless of their tetanus immunization history. | ||||
DTaP = diphtheria and tetanus toxoids, acellular pertussis (for children); Td = tetanus and diphtheria toxoids adsorbed; Tdap = tetanus and diphtheria toxoids, acellular pertussis; TIG = tetanus immune globulin (human). | ||||
Adapted from Centers for Disease Control and Prevention: Wound management for tetanus prevention. Accessed June 5, 2023. | ||||