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Is Tetanus Shot Required After Injury From A Rusty Nail?

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Posted on Wed, 19 Apr 2017
Question: (Ps. I can't figure out how to show you the picture of the scratch. How do I show you the picture? )
Hello I just wanted to make sure I am doing the right thing.

I am helping my boyfriend renovate a house and there are no bathrooms there yet. I had no choice but to pop a squat near the abandoned old rusty barn. As I was kneeling down to pee I brushed up against an old nail head that was sticking out of the barn and scrapped my skin with old wood also.

Here is a picture. It definitely didn't feel like anything penetrated me, just scraped. It hurt a little, there was no blood and it just basically looks like a finger nail scratch. I just want to be safe

What should I do? Go into the ER to get this scratch looked at? (It would take at least 1-2 days to see a doctor where I go to the doctor) I really don't want to go into the ER. How long would I have to get this looked at before it's too late? I would prefer going in to see the doctor rather than ER.

I also got a wipe from my first aid kit and sterilized it with the alcohol wipe

doctor
Answered by Dr. Prof. Kunal Saha (4 hours later)
Brief Answer:
You need not visit the ER for this.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and have checked the attache images. I would insist you to clean the area properly and to keep it open. As such, tetanus is the cause for concern. However, tetanus is an anerobic infection that does not involve open wounds or slight scratches. Apart from general asepsis and application of some antibiotic ointment I would not suggest anything else.

Nevertheless, (not for this episode,) I would insist you to take a course of tetanus toxoids (to be taken stat, after one month, after 6 months, to be repeated after every 5 years thereafter) and a single booster would then protect you for 5 more years.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha (1 hour later)
So from the looks of the scratch you don't think it is necessary to make an appointment to have it looked at by a doctor in person? I really don't want to do that to be honest but if it was necessary I would.
The scratch did have a tiny opening. Not deep penetration, but the nail just lightly jabbed the surface of my skin. I poured hydrogen peroxide on it and tea tree oil. The scratch is minor but the rusty old nail looked really old and disgusting. How often should I be cleaning the scratch? Is peroxide going to be enough? Do you recommend any other form of thorough cleaning?

So you don't think it's going to turn into tetanus? I of course went online and researched tetanus using google (which is not always a reliable source of information I already know this) - said you could get tetanus with even a small scratch.
Also I have had all my vaccinations in the past recommended including tetanus shots. My last tetanus shot was probably junior high school though so it has been past 10 years.

Do you think I will be fine just cleaning the scratch with peroxide and waiting until it heals? Any other actions that need to be taken?

If necessary I will request a tetanus shot my next check up at my doctors which will be in April. Will that be necessary?

doctor
Answered by Dr. Prof. Kunal Saha (2 hours later)
Brief Answer:
Queries answered one by one.

Detailed Answer:
Thanks for writing back. Since it is not a deep and lacerated wound you need not worry. Please do not fiddle or clean the wound. Just apply some antibiotic ointment and leave it on its own. No peroxide needed. Peroxide is damaging to the tissues and needs to be used only if there is requirement to clear off scab and debris. That is not the case here.

Since it is not a deep and lacerated wound it is unlikely to be contaminated with tetanus. If you want to feel safe you can get the course of tetanus toxoids (as suggested). If you really suspect that you could get tetanus, merely taking tetanus toxoid would not suffice and you would need to take tetanus immunogolbulin at the earliest. I doubt if that is required. The choice is yours to make.

Since the last tetanus shot has been taken more than 5 years back your current immunity is to be considered inadequate. However, you can take the course once again as suggested.

You should not keep cleaning the wound. You should not use peroxide. You should definitely wait for it to heal. It would take a week or so. No other actions need to be taken.

Sorry to state rudely, if you had really gotten tetanus, unless you had got tetanus immunoglobulin, you would not last till the next check up in April. However, I would insist you not to panic. Since immunity to tetanus is important, I would insist you to get the full course of tetanus toxoids administered.

Stay relaxed.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha (21 hours later)
I am going to leave the scratch alone and wait for it to heal since you are confident I don't need to worry about it.
I will request a tetanus shot for my check up in April. How many shots would I have to take? Is there a series of several?
Worst case scenario what would happen if I started to feel tetnus symptoms in a week?

Would I be doomed for life? Would it be permanently there forever? Would I have to take medicine for awhile?
doctor
Answered by Dr. Prof. Kunal Saha (45 minutes later)
Brief Answer:
A series of vaccines are needed

Detailed Answer:
Thanks for writing back.

When you request a tetanus toxoid shot you need to take one stat, after one month, one after 6 months, and one after 5 years, to be repeated after every 5 years thereafter.

You either get tetanus or you don't. There is nothing intermediate. I would insist you to relax and not panic about it. If symptoms were to occur, they would have already occurred. So, stop considering ominous possibilities.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

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Is Tetanus Shot Required After Injury From A Rusty Nail?

Brief Answer: You need not visit the ER for this. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone carefully through your query and have checked the attache images. I would insist you to clean the area properly and to keep it open. As such, tetanus is the cause for concern. However, tetanus is an anerobic infection that does not involve open wounds or slight scratches. Apart from general asepsis and application of some antibiotic ointment I would not suggest anything else. Nevertheless, (not for this episode,) I would insist you to take a course of tetanus toxoids (to be taken stat, after one month, after 6 months, to be repeated after every 5 years thereafter) and a single booster would then protect you for 5 more years. Regards