What to do if a rusty nail pierces your foot

Many people get their feet punctured, and most of them just deal with it casually and don't take it seriously. If there is no bleeding and the injury is not particularly serious, it is okay. However, if the skin is broken and bleeding, it is best to go to the hospital for a tetanus shot, because the nails used for embroidery are often contaminated with bacteria and dust, and the lack of oxygen deep in the wound can easily cause unnecessary trouble to the wound if not treated in time.

To prevent tetanus

If you accidentally step on a rusty nail, on the one hand, the wound may be contaminated by the bacterial dust contained in the rust, and on the other hand, the oxygen-deficient environment deep in the wound is conducive to the germination of tetanus spores. Therefore, if you are pricked by a rusty nail, it is recommended to go to the hospital for active treatment to avoid unnecessary trouble.

When you arrive at the hospital, the first thing to do is to undergo a thorough surgical debridement of the wound to try to avoid the oxygen-deficient environment required for the growth of Clostridium tetani. Then, in order to further reduce the risk of tetanus, you have to consider whether you should get an injection.

There are actually two types of "tetanus shots" that people often talk about:

One is tetanus toxoid, which is a tetanus vaccine made from antigen;

The second is immunoglobulin, which is an antibody. Depending on its source, it is divided into tetanus antitoxin (TAT, also known as "horse tetanus") and tetanus immunoglobulin (TIG, also known as "human tetanus").

When not injured:

The best way to prevent tetanus is to get vaccinated, which provides immunity for up to 10 years.

Vaccination works by acting on the body's immune system through antigens. The human body will produce corresponding antibodies to neutralize the neurotoxins secreted by bacteria, thereby protecting the nervous system and preventing disease. After receiving 3 or more doses of tetanus vaccine for three consecutive months, almost everyone can produce enough antibodies, and the immune protection period can last up to 10 years.

How to prevent injury?

1. During the vaccine protection period: If the wound is shallow, small, clean, and there is no foreign body embedded in the flesh, no injection is required after debridement. When the wound is large, deep, and severely contaminated, a booster injection of tetanus toxoid (also known as the vaccine) can be given to quickly increase the antibody level in the body.

2. Expiration of vaccine protection period: If the last booster vaccination was 10 years ago, regardless of the wound condition, it is recommended to give a booster shot of vaccine to provide long-term protection.

3. Not vaccinated: If you have not received the tetanus vaccine, the vaccination is incomplete or you can’t remember the vaccination time. When the wound is shallow and small, the possibility of tetanus is small. Tetanus vaccine should be injected for 3 consecutive months to encourage the body to produce protective antibodies. It is recommended to booster vaccination every 10 years. If the wound is of the type mentioned above that carries a higher risk of tetanus, TAT or TIG should be injected immediately to provide short-term rapid protection, while tetanus vaccine should be injected regularly to provide long-term protection.

Not every wound requires you to rush to the hospital to get a tetanus shot immediately. Whether the shot is needed should be determined based on the patient's own immunization status and wound type. If the patient has sufficient protective antibodies, no matter how many antibodies he or she receives, it will not provide much help.

It is not advisable to rush to the hospital to get immunoglobulin as soon as you get a nail piercing your foot or a knife cutting your hand. Not only is it a waste of medical resources, but the potential adverse reactions of TAT injections should not be underestimated. Of course, we should not delay the treatment of the disease by neglecting the debridement of the wound just because we have vaccines or antibodies.