Localized tetanus bacillus infection following open metatarsal fracture in an adult: A case report

From this case, we conclude that the elderly are not actively immunized against tetanus and tetanus vaccination is recommended for those over 65 years of age. Open wound patients first seen at an outside hospital to ensure and perform passive immunization. In the management of open wounds, preoperative bacteriological culture of fresh wounds in the emergency department is essential to guide therapeutic use of medications to prevent the development of infection and target anti-infective therapy. Early and thorough debridement of open wounds is effective in removing residual tetanus bacilli and their spores from the wound and reducing the release of toxins. Ineffective nerve block anesthesia can be used as a reference indicator of tetanus bacillus infection to aid diagnosis and treatment. Closed negative pressure drainage of the wound promotes the propagation of anaerobic bacteria, and the use of closed negative pressure drainage of the wound is avoided when the bacteria suspected of infection are anaerobic bacteria. Vancomycin bone cement has many advantages, such as long duration of action and small side effects, which can effectively control the infection.