Tetanus is a specific infection related to trauma, which is caused by the bacillus tetanus invading the body through skin or mucous membrane wounds, growing and multiplying in a hypoxic environment, producing toxins and causing paroxysmal muscle spasms. Because the incubation period is usually 7 to 8 days, so commonly known as “seven days of wind”. The incubation period can be as short as 24 hours or as long as several months or years. The shorter the incubation period, the worse the prognosis. Clostridium tetani is a specialized anaerobic, Gram stain positive. Usually exist in the intestinal tract of animals and humans, with the feces out of the body, in the state of budding cells distributed in nature, especially in the soil is common. This bacterium has strong resistance to the environment and can resist boiling. The contamination rate of traumatic wounds is high, and the contamination rate in the battlefield can reach 25% to 80%. However, the incidence of tetanus is only 1% to 2% of those contaminated, suggesting that the onset must have other factors, the main factor is the hypoxic environment. In trauma, Clostridium tetani can contaminate deep tissues (such as blind canal trauma, deep stab wounds, etc.). If the external wound opening is small and the wound is filled with necrotic tissue or blood clots, or if the filling is too tight, local ischemia, etc., a hypoxic environment suitable for the growth and reproduction of the bacterium is formed. If there is also an aerobic bacterial infection, the latter will consume the oxygen remaining in the wound, making the disease more likely to occur. Clostridium tetani only proliferates under hypoxic conditions. The spasmotoxin produced by Clostridium tetani after death binds irreversibly to neuroreceptors in the spinal cord and brainstem, etc., and is the main factor causing the disease, with a mortality rate of 10-30%. However, this is not the case with the traumas we encounter in our daily lives! Outpatient clinics often encounter superficial wounds with superficial abrasions and large traumas also flock to tetanus. In fact, these wounds do not need tetanus at all as long as they are treated with timely debridement. Why? Let’s look at two principles of tetanus prevention: thorough debridement and early prevention. The importance of thorough debridement is much higher than tetanus, and even timely and thorough debridement can be done without tetanus. Of course, whether the tetanus shot is not important? Not exactly. For example, in patients with longer injuries (greater than 24 hours), because of the lack of timely debridement and the increased likelihood of Clostridium tetani multiplication, coupled with the incubation period of Clostridium for 3-21 days, prophylactic tetanus injections are particularly important as long as there are no symptoms. There are two types of tetanus prophylaxis strategies: active and passive immunization, the former for tetanus toxoid antigen, for clean or slightly contaminated wounds, only tetanus toxoid can be injected 3 times, the first and second interval of 4 weeks, the third has 6-12 months when used, and the later interval of 10 years for prophylaxis, without having to inject tetanus immunoglobulin; the latter for tetanus immunoglobulin and tetanus antitoxin. For more serious contaminated wounds, it is the same time to inject tetanus immunoglobulin and tetanus antitoxin, note that you can not inject the same part, otherwise it will not work.