Analysis of clinical characteristics and tetanus prevention and management of 586 emergency patients with open wounds_West China Medical Journal

Authors：

MAO Xiaoyong ¹ , LONG Rui ¹ , LIU Huijun ¹ , QIN Xin ¹ , XIAO Xiangwen ¹ , YANG Jing ¹ , HUANG Ling ¹ ,  LI Yang ²

1. Department of Emergency Medicine, Medical Center of Trauma and War Injury, Daping Hospital, Army Medical University, Chongqing 400042, P. R. China;
2. Department of Emergency Medicine, Medical Center of Trauma and War Injury, Daping Hospital, Army Medical University, State Key Laboratory of Trauma and Chemical Poisoning, Chongqing 400042, P. R. China;

Corresponding?author：

LI Yang, Email: dpliyang@tmmu.edu.cn

Keywords：

Open wounds; tetanus; clinical characteristics; emergency patients; standard management

DOI：

10.7507/1002-0179.202510115

Video：

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Objective To analyze the clinical characteristics of patients with open wounds, evaluate the standardization of tetanus prevention measures, and provide evidence for optimizing tetanus prevention and control strategies. Methods The clinical data of patients with open wounds admitted to the Department of Emergency Medicine of Daping Hospital, Army Medical University between June 1 and August 31, 2025 were retrospectively collected, including demographic characteristics, wound types, immunization history, active/passive immunization and other information. Combined with the relevant norms, guidelines and consensus of tetanus prevention and treatment, the clinical characteristics of patients and whether tetanus prevention measures were standardized were analyzed. Results A total of 586 patients with open wounds were included, involving 6 attending surgeons. The age of patients with open wounds ranged from 4 to 91 years old, with a median of 42 years old, mostly young and middle-aged men. The wound types of patients with open wounds were mainly cutting wounds (213 cases), with a total of 246 cases of high-risk wounds, and the limbs were the main injury sites (423 cases). 562 patients (95.90%) had unknown immunization history or did not complete the whole course of immunization, and only 37 patients (6.31%) completed the standard whole course of immunization. The median time from injury to consult doctors was 3 h. The proportion of delayed treatment (≥ 6 h), the use rate of passive immunization and the overall standard disposal rate of patients with high-risk wounds were higher than those of patients with low-risk wounds (P<0.05). The standard immunization rate of elderly people ≥ 65 years old (18.09%) was lower than that of young and middle-aged people (30.12%). Conclusions Open wound patients were predominantly young and middle-aged, with a high proportion of high-risk wounds. However, tetanus prevention measures lacked standardization, particularly low immunization coverage among the elderly.

Citation： MAO Xiaoyong, LONG Rui, LIU Huijun, QIN Xin, XIAO Xiangwen, YANG Jing, HUANG Ling, LI Yang. Analysis of clinical characteristics and tetanus prevention and management of 586 emergency patients with open wounds. West China Medical Journal, 2025, 40(11): 1783-1787. doi: 10.7507/1002-0179.202510115 Copy

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21.	張丹丹, 趙玲璐, 劉銘, 等. 貴州省醫療機構外傷后破傷風預防處置現狀調查. 貴州醫藥, 2024, 48(10): 1558-1560.
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24.	Ghotloo S, Amiri MM, Hassani D, et al. Enhanced in vivo tetanus toxin neutralizing potency of an anti-toxin monoclonal antibody following antibody chimerization. J Biochem Mol Toxicol, 2025, 39(11): e70595.

1. 劉斯, 劉珵, 劉佳陽, 等. 《非新生兒破傷風診療規范(2024 年版)》要點解讀. 中華流行病學雜志, 2024, 45(11): 1468-1476.
2. Yen LM, Thwaites CL. Tetanus. Lancet, 2019, 393(10181): 1657-1668.
3. Bhagwat B, Sarangi BU, Walimbe A, et al. Intensive care management and outcomes of severe paediatric tetanus in a tertiary care hospital. Trop Doct, 2025, 9: 494755251375218.
4. Casey RM, Nguna J, Opar B, et al. Field investigation of high reported non-neonatal tetanus burden in Uganda, 2016-2017. Int J Epidemiol, 2023, 52(4): 1150-1162.
5. Liang Z, Liu S, Guo W, et al. Recombinant monoclonal antibody siltartoxatug versus plasma-derived human tetanus immunoglobulin for tetanus: a randomized, double-blind, active-controlled, phase 3 trial. Nat Med, 2025, 31(8): 2673-2681.
6. World Health Organization. Tetanus vaccines: WHO position paper-February 2017. Wkly Epidemiol Rec, 2017, 92(6): 53-76.
7. Chen X, Zhang M, Zhao Y, et al. Current status and factors of vaccine hesitancy in tetanus vaccination among traumatic patients - China, 2024. China CDC Wkly, 2025, 7(13): 441-448.
8. Gou Y, Li SM, Zhang JF, et al. 6084 cases of adult tetanus from china: a literature analysis. Infect Drug Resist, 2023, 16: 2007-2018.
9. An ZJ, Gao L, Lv P. Elimination of neonatal tetanus in China: a milestone in public health. Bull World Health Organ, 2013, 91(4): 316.
10. 宋欣. 石家莊、南京兩市人群創傷后破傷風疾病負擔及基層醫務人員破傷風防治知識知曉情況調查. 中國疾病預防控制中心, 2020.
11. 麥浩, 劉穎, 龍虎, 等. 2015-2017 年桂林市全人群破傷風流行特征調查. 中國急救復蘇與災害醫學雜志, 2018, 13(11): 1084-1086.
12. Centers for Disease Control and Prevention (CDC). Tetanus surveillance --- United States, 2009-2017. MMWR Morb Mortal Wkly Rep, 2019, 68(13): 291-296.
13. 王傳林, 劉斯, 邵祝軍, 等. 外傷后破傷風疫苗和被動免疫制劑使用指南. 中華預防醫學雜志, 2019, 53(12): 1212-1217.
14. Jeremijenko A, McLaws ML, Kosasih H. A tsunami related tetanus epidemic in Aceh, Indonesia. Asia Pac J Public Health, 2007, 19: 40-44.
15. 麥國鳳. 236 例非新生兒破傷風流行病學特征研究. 南寧: 廣西醫科大學, 2022.
16. 中華預防醫學會, 尹遵棟, 王傳林. 破傷風高風險人群主動免疫制劑使用專家共識. 中國預防醫學雜志, 2024, 25(6): 641-649.
17. Finkelstein P, Teisch L, Allen CJ, et al. Tetanus: a potential public health threat in times of disaster. Prehosp Disaster Med, 2017, 32(3): 339-342.
18. 徐吉, 黃國慶, 楊寧, 等. 1990-2021 年中國破傷風流行病學負擔分析. 中國感染控制雜志, 2025, 24(7): 923-931.
19. Centers for Disease Control and Prevention (CDC). Tetanus surveillance --- United States, 2001-2008. MMWR Morb Mortal Wkly Rep, 2011, 60(12): 365-369.
20. 李建橋, 陳靜, 劉瑜, 等. 2024 年重慶市醫院急診科醫務人員外傷后破傷風和免疫制劑使用知識調查. 中國疫苗和免疫, 2025, 31(1): 41-46.
21. 張丹丹, 趙玲璐, 劉銘, 等. 貴州省醫療機構外傷后破傷風預防處置現狀調查. 貴州醫藥, 2024, 48(10): 1558-1560.
22. Ghotloo S, Golsaz-Shirazi F, Amiri MM, et al. Neutralization of tetanus toxin by a novel chimeric monoclonal antibody. Toxicon, 2021, 201: 27-36.
23. Li Y, Chen Y, Cui J, et al. Preparation and characterization of a neutralizing murine monoclonal antibody against tetanus toxin. J Immunol Methods, 2023, 513: 113427.
24. Ghotloo S, Amiri MM, Hassani D, et al. Enhanced in vivo tetanus toxin neutralizing potency of an anti-toxin monoclonal antibody following antibody chimerization. J Biochem Mol Toxicol, 2025, 39(11): e70595.

West China Medical Journal

Analysis of clinical characteristics and tetanus prevention and management of 586 emergency patients with open wounds

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