Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Retrograde transport
In Normal Condition …….
In Tetanus Condition …….
TREATMENT
The define goals of
treatment include the
following :
1. Halting production of toxin
within the wound
(eradication source)
2. Neutralization of unbound
toxin
3. Control muscle spasm
4. Treatment of autonomic
instability
5. Supportive therapy
6. Management of
complications
Halting production of toxin
within the wound
Debride the wound
&
Removing of all necrotic tissue & foreign
material from the wound > good media
for bacterial growth
Antimicrobial Drugs
Source eradication : Most Important
Wound management
– Eradicate vegetative & Spores , and change
condition for germination thereby preventing
elaboration & absorption neurotoxin
– Good Debridement
Too tight, leave it
open
Source eradication
Bacterial biofilm
D E
R I
EB
D
More than once
Neutralization Unbound Toxin
This achieved through PASSIVE
IMMUNISATION that should be
undertaken as early as possible since
the toxin became once its bound to
nerve terminus
Passive Immunisation
•Human Immunoglobulin
•No Preservatives
•Skin test Not Necessary
•Risk Allergy : Not Reported ("anti complementary aggregates of globulin)
•About 4 weeks protection, fetal protection
•7 unit Ig/IU
•Prophylaxis Dosage : 250 IU (IM)
•Therapeutic Dosage : 3000-6000 IU in IM one shot
•Expired date : 36 months
•Relative High Price, widely distribution, repeated doses
Anti Tetanus Serum
•C/I : History of Hypersentivity to Ig
•Equine serum
•Preservatives Phenol 0,25%
•Skin test Necessary
•Risk Allergy : Reported Anaphylaxis 1/10.0000
•About 1 weeks protection, No fetal protection
•1 unit Ig/IU
•Prophylaxis Dosage : 1500 IU (IM)
•Therapeutic Dosage : 100.000 IU -200.000 divided in IM & IV
•Expired date : 24 months
•Cheap price, available, not possible repeated doses
•C/I : History of Anaphylaxis / drugs allergy
HOW DOES IMMUNOGLOBULIN WORKS ?
Ig
For treatment: The dose of tetanus
immunoglobulin for intravenous use is
5000–10,000 IU by infusion (depend on the
country).
Prophylaxis Dosage
Managemet Protocol for
Tetanus
Conclusion
1. Tetanus still exist
2. Diagnosis based on Clinical presentation
3. Treatment : Source eradication &
Supportive treatment
4. Most important : Good Debridement
5. Human Tetanus Immunoglobulin may used
for Treatment & wound prophylaxis.
6. Prevention is the best
THANK YOU