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Tetanus-prone wound — MCCQE Part 1 MCQ

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ModerateWoundsTetanus-prone woundMCCQE Part 1

A 31-year-old farm worker presents 14 hours after a contaminated laceration to the forearm. The wound is irrigated and suturing is being considered. He received his childhood vaccines but has not had a tetanus booster for 18 years. What is the most appropriate screening/prevention?

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Correct answer: E — Give tetanus-diphtheria-containing booster vaccine

A contaminated wound in a person with remote immunisation requires a tetanus-containing booster. Tetanus immune globulin is generally reserved for incomplete or uncertain primary immunisation or high-risk wounds in inadequately immunised people. Childhood vaccination does not guarantee adequate booster protection after 18 years. Hepatitis B immune globulin and acyclovir are not relevant to a soil-contaminated laceration.

Reference: Canadian Immunization Guide, NACI