Discussion
A 10-year old boy following a road traffic accident presents to the casualty with a contaminated wound over the left leg. He has received his completed primary immunization before preschool age and received a booster of DT at school entry age. All of the following can be done except:
Answer: B
Correct answer: Injection of human antiserum
The boy has had a complete primary course and a booster at school entry, so he is immune and needs only a booster dose of toxoid for this contaminated wound; passive immunisation adds nothing and carries the risks of a serum product. The other three are all appropriate: tetanus toxoid, antibiotics, and above all thorough debridement and cleaning, which removes the devitalised tissue in which clostridia would otherwise grow.
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