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Tetanus Prophylaxis in Routine Wound Management

Tetanus Prophylaxis in Routine Wound Management

History of Adsorbed Tetanus Toxoid

Clean, Minor Wounds

All Other Wounds*

DTaP, Tdap, or Td†

TIG‡

DTaP, Tdap, or Td†

TIG‡

Unknown or < 3 doses

Yes

No

Yes

Yes

≥ 3 doses

Yes if ≥ 10 years since last dose

No

Yes if ≥ 5 years since last dose

No

* Such as (but not limited to) wounds contaminated with dirt, feces, soil, or saliva; penetrating or puncture wounds; crush injuries; compound fractures; avulsions; necrotic or gangrenous wounds; and wounds resulting from burns or frostbite.

† DTaP is recommended for children < 7 years of age. For patients ≥ 11 years of age who have not previously received a dose of Tdap, a single dose of Tdap should be given. Patients ≥ 7 years of age who are not fully immunized against pertussis, tetanus, or diphtheria should receive one dose of Tdap for wound management and as part of the catch-up series.

‡ People with HIV infection or severe immunodeficiency who have contaminated wounds should also receive TIG, regardless of their tetanus immunization history.

DTaP = diphtheria and tetanus toxoids, acellular pertussis (for children); Td = tetanus and diphtheria toxoids adsorbed; Tdap = tetanus and diphtheria toxoids, acellular pertussis; TIG = tetanus immune globulin (human).

Adapted from Centers for Disease Control and Prevention: Clinical Guidance for Wound Management to Prevent Tetanus. June 10, 2025. Accessed August 15, 2025.

* Such as (but not limited to) wounds contaminated with dirt, feces, soil, or saliva; penetrating or puncture wounds; crush injuries; compound fractures; avulsions; necrotic or gangrenous wounds; and wounds resulting from burns or frostbite.

† DTaP is recommended for children < 7 years of age. For patients ≥ 11 years of age who have not previously received a dose of Tdap, a single dose of Tdap should be given. Patients ≥ 7 years of age who are not fully immunized against pertussis, tetanus, or diphtheria should receive one dose of Tdap for wound management and as part of the catch-up series.

‡ People with HIV infection or severe immunodeficiency who have contaminated wounds should also receive TIG, regardless of their tetanus immunization history.

DTaP = diphtheria and tetanus toxoids, acellular pertussis (for children); Td = tetanus and diphtheria toxoids adsorbed; Tdap = tetanus and diphtheria toxoids, acellular pertussis; TIG = tetanus immune globulin (human).

Adapted from Centers for Disease Control and Prevention: Clinical Guidance for Wound Management to Prevent Tetanus. June 10, 2025. Accessed August 15, 2025.

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