To do Tetanus Immunoglobin or Not? Help.

[erica57401]

Hi All:

3 year old DD stepped on a piece of metal - tiny like a sewing needle - that was outside following the new siding that was put on our house. The piece of metal was not dirty, but had been outside on top of the grass for less than a week. 

The piece was maybe 1/8th of an inch into her skin and went in sideways similar to a sliver. DH said that it was red and bloody, he pulled it out as it went in and then it bled quite a bit, a blob about the size of a bean. It stopped bleeding after about one minute of pressure. I squeezed it and made it bleed. I also squeezed it and poured peroxide into the wound. 

DD hasn't been vaccinated for tetanus. I'm not inclined to get her an immunoglobin shot, but I'd hate to have something go wrong. Just getting your opinions as fellow non-vaccinating moms. Should I get her the shot??

[Monkeygrrl]

I would not. It's not that deep, you made sure oxygen got into the wound, and you've clean it appropriately. I would just continue to watch it like you would any other wound for the next couple of days to make sure it's healing well. 

[shiningpearl]

I really can't answer your question, but I can relate to your worries.  Let me ask you this, if it had been a piece of glass that had been there for who knows how long would you still worry about tetanus?  Rusty metal has been associated with tetanus because of the uneven surface that can collect spores and leave foreign material in the wound (at least that is my understanding). 

With it bleeding and being cleaned, I don't know if I would get the Tig, But I would keep a close eye on it and take her in if you notice anything, and please read up on the symptoms and treatment of tetanus.  But while I'm not sure how many un-vaccinated children there are, or how many adults haven't had there 10 year booster, there are still only about 40 cases a year, most of which are in those over 60 years old or who have circulation problems. 

[erica57401]

The piece of metal was like a thin piece of metal wire...thinner than a sewing needle and absolutely no rust was on it at all.  It was squeaky clean.  It had been sitting out in our yard, on top of our grass for no more than a week.  It was a new material used by the siding company who put siding on our house last week.  It was not old and certainly not dirty.  The wound looks perfectly clean.  Tomorrow I will re-open it and re-clean it.  

Worrying about it seems ridiculous and I know that, however, it is just the scenario I dreaded and so....here I am.

[shiningpearl]

I can understand, just trying to help you put some perspective on it.

[Marnica]

The wound bled - profusely according to you. No I would not be concerned. I don't think a doctor would advise a TIG under the circumstances you describe either. Tetanus spores connot survive in oxegenated enviromnents. I think you are good!

[RSchecter]

I agree. Even in the pre-vaccine era tetanus was exceedingly rare. And that was back when we all lived on farms and around horses: the most likely place to find tetanus. Besides since many don't get the ten year booster, millions of adults have no immunity and they certainly suffer minor injuries such as the one you describe without having themselves treated for tetanus. And still cases of tetanus are almost non-existent.

[VaccineMachine]

Also there are certain wounds known as tetanus prone wounds. The wound you describe has none of the characteristics of such a wound

Tetanus-Prone Wounds Wounds more than 6 hours old. Jagged or avulsed wounds. Wounds caused by missile, crushing mechanism, heat, or cold. Wounds with clear signs of infection. If wound has been contaminated with dirt, feces, soil, or saliva. Circulation-compromised wounds.

http://webhome.broward.edu/~jlarson/EmergencyNursing/02ClinicalFoundations/6_WoundCare/23TetanusProneWounds.htm

[erica57401]

The bottom of her feet were very dirty from normal summer kid play and that is all that concerns me.  That and the wound closed up very quickly.  It is red around the entrance point, but I assume that is from me squeezing it open and pouring peroxide into it.  

Thanks all for the reassurance.