Table 10-11.

Indications for Tetanus Prophylaxis in Wounds

	Clean, Minor Wound		All Other Wounds*
History of Absorbed Tetanus Toxoid (Doses)	Tdap or Td†	TIG	Tdap or Td†	TIG
Unknown or <3	Yes	No	Yes	Yes
≥3	No‡	No	No§	No

^*Such as, but not limited to, wounds contaminated with dirt, feces, soil, and saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns, and frostbite.

^†Tdap is preferred to Td for adults who have never received Tdap. Td is preferred to TT for adults who received Tdap previously or when Tdap is not available. If TT and TIG are used, tetanus toxoid absorbed rather than tetanus toxoid for booster use only (fluid vaccine) should be used.

^‡Yes, if ≥10 years since the last tetanus toxoid–containing vaccine dose.

^§Yes, if ≥5 years since the last tetanus toxoid–containing vaccine dose.

From Kretsinger K, Broder KR, Cortese MM et al: Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel, MMWR Recomm Rep 55(RR-17):1, 2006.