Tetanus antitoxin (TAT) is a serum that contains specific antibodies that neutralize tetanus toxin. Since this serum contains specific antibodies that neutralize tetanus toxin, it can be used for the prevention and treatment of Clostridium tetani infection. There are two sizes: 1) 1500 IU (for prevention) (2) 10000 IU (for treatment), and we commonly see the former in clinical practice. So, what is tetanus? Is it necessary to inject tetanus antitoxin as a preventive measure for every trauma, regardless of its size and depth? Is the injection of TAT harmless? Is it necessary for every group of people to be injected? These questions are common and often confusing to everyone. Tetanus is an infectious disease caused by infection with the bacillus tetanus, and the incubation period of the disease varies, usually from 7 to 8 days. In patients who have received antitoxin prophylaxis, the incubation period may be extended to several weeks. The incubation period can be as short as 1 to 2 days in individual cases. The diagnosis of tetanus should be made without difficulty based on the history of traumatic infection, early onset of dental closure, and cervical straightening, coracoacusis and respiratory distress due to spasm of skeletal muscles in various parts of the body. If not treated in time, the mortality rate is about 10-40%. Let’s look at tetanus bacillus, it exists in large numbers in the intestinal tract of humans and animals, contaminated soil by feces, infected by wounds cause disease. Clostridium tetani in nature can be invaded by wounds, germination and reproduction and cause disease, but Clostridium tetani is anaerobic bacteria, in general wounds can not grow, the anaerobic environment of the wound is an important condition for Clostridium tetani infection. So how to properly treat trauma to prevent tetanus? 1, tetanus clostridium grows in mud and rust, so in deeper wounds stained with mud or by rust type iron lacerations should be injected tetanus antitoxin. 2, if only rub the epidermis, the wound is not deep, as long as the appropriate debridement, do not need to inject tetanus antitoxin. Or use some antiseptic solution such as iodine volt external rub can be. If the wound surface has been dry, no exudate, can not need to wipe. 3, because tetanus antitoxin is an immune horse serum, the human body is a heterogeneous protein, with antigenicity (allergic reaction), so before using the drug for allergy testing. If the test result is negative, tetanus antitoxin can be injected directly, and if the test result is positive, desensitization injection should be performed, that is, small doses of tetanus antitoxin should be injected in 4-5 times. In those who have used tetanus antitoxin for more than a week, if used again, a skin test must also be repeated. How to prevent tetanus? TT is non-toxic, reliable and does not cause serum allergic reactions. The specific method is: before and after a total of three injections, each 0.5 ml. after the first subcutaneous injection of adsorbed refined tetanus toxoid, an interval of 4 to 8 weeks, and then the second subcutaneous injection, you can obtain basic immunity. If the 3rd injection is given after 6 months to 1 year, a more stable immunity can be obtained. This immunity can be maintained for more than 10 years, and subsequently (e.g., 5 years) an additional injection (0.5 ml) will maintain stable immunity. Tetanus vaccines currently used for active immunization are formulated with tetanus toxoid and include diphtheria, pertussis, and tetanus triple vaccine (DPT), diphtheria and tetanus combination vaccine (DT), tetanus and attenuated diphtheria combination vaccine (Td), and single tetanus toxoid (TT). Passive immunization methods include tetanus antitoxin (TAT) and human tetanus immunoglobulin (TIG). Currently, TAT injection has become a routine for the management of open wounds in most hospital outpatient and emergency departments. However, equine serum proteins are highly allergenic to humans, and the clinical report of positive skin test rate is as high as 54.2%. Allergic reactions have been reported in both negative skin test direct injections and positive desensitization injections of TAT, and even death due to anaphylaxis is common. Some scholars believe that the dangerous incidence of TAT injection is even much higher than the risk of tetanus infection. Combined with the situation in our country, grasp some principles as follows: 1. Prevent all sizes of trauma. As tetanus bacillus (anaerobic bacillus) is widely stored in human and animal feces, dust and environment, it cannot invade normal skin and mucous membrane, but can only invade the body when there is trauma. The deeper the wound is, the easier it is to be infected and develop. 2, the most reliable prevention of tetanus onset is the injection of tetanus toxoid. Children with pertussis, diphtheria, tetanus mixed vaccine injection, can guarantee 5 to 10 years without this disease. Newborns and children around one year old, considering that they have not yet received planned immunization or have received immunization but may not have established immunity, in case of accidental injury, depending on the size and depth of the wound and contamination, still need to inject tetanus antitoxin, the dose is the same as adults. 3.Wounds that are small, superficial, clean, and do not require sutures after debridement can be injected without antitoxin. Adults and adolescents with trauma, deeper wounds or heavier contamination must be injected with tetanus antitoxin in addition to strict surgical debridement and suturing. Children between the ages of 3 and 10 years old, with clear immunization plans, do not need to be injected after wound debridement for smaller wounds, but still need to be injected if the wound is deep or heavily contaminated. 4. Inject tetanus antitoxin as soon as possible after injury, usually no later than 24 hours. However, if the injury is longer, the TAT is not injected in time, the contamination is heavier, and the wound is deeper, in addition to strict surgical debridement, the wound must be open and not sutured, and the antitoxin (TAT) and toxoid (TT) must still be injected around the wound.