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Physicians are obligated to include prophylaxis against tetanus in all patients who have "tetanusprone" wounds or injuries. A tetanus-prone wound is one that has been potentially contaminated with tetanus spores or organisms, particularly in the presence of dead or dying tissue and an atmosphere of low-oxygen tension in the depths of the wound, which is conducive to the growth of anaerobic organisms. If the patient has received a basic and complete course of immunization by means of tetanus toxoid and has received a "booster" injection within five years of the present injury, another booster dose of fluid tetanus toxoid should suffice in the presence of a tetanus-prone wound or injury. If the period following active immunization or administration of a booster dose of toxoid has been longer than five years, the administration of 1,500 units or more of tetanus antitoxin given along with the toxoid booster, but in a different
TETANUS IMMUNIZATION. JAMA. 1956;161(9):883. doi:10.1001/jama.1956.02970090109019
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