Tetanus Prophylaxis for Diabetic Foot Ulcers

Because of better immunization practices in the United States, tetanus is becoming proportionally less frequent in the classic farming or soil-contaminated wounds and more common in the atypical wounds like diabetic foot ulcers that have exposure only to indoor environments. Tetanus is a rare but serious and potentially fatal complication of diabetic foot ulcers and infections. Because diabetics are at greater risk for tetanus intoxication and have a higher case-fatality ratio, updating the immunization status of patients who have ulcers should become a part of wound healing protocols. Diabetic foot wounds should be considered tetanus-prone wounds, and tetanus toxoid should be administered if indicated according to the guidelines in this article.