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.