Which one of the following is not a wound prone to the development of tetanus?
Donor site of a split-thickness skin graft
The correct answer is the donor site of a split-thickness skin graft. Tetanus is caused by Clostridium tetani, a spore-forming, strictly anaerobic Gram-positive bacillus whose toxin tetanospasmin blocks glycine and GABA release, causing trismus, risus sardonicus and opisthotonus. Spores germinate only at a low oxidation-reduction potential, which needs dead tissue, soil, foreign bodies or deep puncture. A graft donor site is a fresh, superficial, sterile, well-vascularised surgical wound with no devitalised tissue, so it is not tetanus-prone.
A compound fracture of the tibia is tetanus-prone because crushed muscle and exposed bone create an anaerobic focus. A forearm wound contaminated with soil is the classical high-risk wound, soil and manure being the natural reservoir of spores. A dog bite is a deep puncture with closed tissue planes and inoculated saliva, again anaerobic (and additionally needing rabies prophylaxis).
Key point: Tetanus-prone wounds are those more than 6 hours old, or with devitalised tissue, soil contamination, puncture, burns or foreign bodies. Clean, fresh, surgically created wounds are not.
Important Questions from Wounds
Which of the following are risk factors for wound infection?
1. Malnutrition
2. Poor perfusion
3. Antibodies
4. Foreign body material
Select the correct answer using the code given below.
Which of the following are types of wound healing?
1. Primary Intention
2. Secondary Intention
3. Tertiary Intention
4. Quaternary Intention
Select the correct answer using the code given below :
Untidy wounds are characterised by which of the following ?
1. Crushed or avulsed tissues
2. Contamination wound
3. Devitalised tissue
4. No loss of tissue
Select the correct answer using the code given below :
Which of the following are types of wound healing?
1. Primary Intention
2. Secondary Intention
3. Tertiary Intention
4. Quaternary Intention
Select the correct answer using the code given below :- Untidy wounds are characterised by which of the following?
1. Crushed or avulsed tissues
2. Contamination wound
3. Devitalised tissue
4. No loss of tissue
Select the correct answer using the code given below :
