Exploration of the wound in emergency rooms is not indicated, if operative intervention is planned to
decrease risk of further contamination. After removal of obvious foreign bodies and acquiring trauma
radiographs, wounds are covered with saline socked gauze. Appropriate antibiotic coverage and tetanus
prophylaxis should be given. The current dosage of toxoid is 0.5ml regardless of age, and immune
globulin is 75U for 10years. They should be injected
intramuscularly each from a different syringe and into different sites. Recommended Tetanus Prophylaxis
is based on patient immunization history and type of wound whether tetanus prone or non tetanus prone.
Non tetanus prone wound is a clean minor wound < 6hours after injury. Tetanus prone is one more than 6
hrs after injury, irregular configuration, > 1cm deep, from missile, crush, burn or frost bite. Below is a
table for requirements of Tetanus Prophylaxis4
.