Discussion
A person has received complete immunization against tetanus 10 years ago. Now he presents with a clean wound without any lacerations from an injury sustained 2.5 hours ago. He should now be given:
Answer: B
Correct answer: Single-dose of tetanus toxoid
The patient completed a primary course, so he needs no immunoglobulin and no fresh course - his immune memory is intact and a booster will raise protective antitoxin within days. Ten years have elapsed, which is exactly the recommended booster interval, so a single dose of toxoid is given. Human tetanus immunoglobulin is reserved for those whose immunisation is incomplete or unknown, and for tetanus-prone wounds in such patients; this wound is clean, unlacerated and only hours old.
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