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Clinical Practice Guidelines

RCH > Division of Medicine > General Medicine > Clinical Practice Guidelines > Management
of tetanus-prone wounds

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Management of tetanus-prone wounds

The new Immunisation Schedule recommends that 10-yearly tetanus boosters are
no longer required up until the age of 50, provided that the primary series of 3
vaccinations plus 2 boosters have been given.
The recommendations for the management of tetanus-prone wounds remain the same.
Types of wounds likely to favour the growth of tetanus organisms include:

compound fractures

deep penetrating wounds

wounds containing foreign bodies (especially wood splinters)

wounds complicated by pyogenic infections

wounds with extensive tissue damage (eg. contusions or burns)

any wound obviously contaminated with soil, dust or horse manure

(especially if topical disinfection is delayed more than 4 hours).

Re-implantation of an avulsed tooth is also a tetanus-prone event, as

minimal washing and cleaning of the tooth is conducted to increase the
likelihood of successful re-implantation.

Wounds must be cleaned, disinfected and treated surgically if appropriate.

History of tetanus vaccination

3 or more doses

Type of wound

Tetanus vaccine booster

(see below)

< 5 years since last dose

All wounds


5-10 years since last dose

Clean minor wounds


All other wounds


All wounds


Clean minor wounds


All other wounds


> 10 years since last dose

< 3 doses or uncertain

A combination vaccine should be used in order to boost community protection

against pertussis:
Please note that CDT and Tetanus Toxoid vaccine are no longer available.

< 8 years old DTPa-IPV (Infanrix-IPV)

> 8 years old dTpa (Boostrix)

Can use a diphtheria/ tetanus toxoid vaccine (ADT ) if pertussis vaccination is



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Last updated 14 May 2014.