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Open wound
My dad -87 yrs got his leg hit against a wooden study table and has a cut wound near his ankle..Last year in December he had a TT injection taken for a similar wound..should he take TT again..also which ointment T-bact or Neosporin is better?Should the wound be bandaged or kept ooen?Please advise..
Answers (16)
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I am Dr Shamoon. Taking your three questions in order for your 87-year-old father. Tetanus: since he received a TT injection in December last year, i.e. less than 12 months ago, he does not need a repeat dose for this clean household cut - a booster is generally given only if the last dose was more than 5 years ago (or more than 10 years for a clean minor wound). The exception would be if this wound is deep, dirty, contaminated with soil or rust, or has crushed/dead tissue - then a doctor may give tetanus immunoglobulin rather than just TT, especially at his age. Ointment: T-bact (mupirocin) is the better choice. It covers Staphylococcus, the organism that actually infects skin wounds, is well tolerated, and is what I would use here. Neosporin contains neomycin, which is a fairly common cause of contact allergic dermatitis on elderly leg skin and can make a wound look worse. Dressing: an open wound heals better kept covered and moist, not open and dry - so cover it with a sterile non-adherent dressing rather than leaving it exposed. Please also remember that ankle-area wounds in the elderly are the slowest to heal because of reduced blood supply, and if he is diabetic or has varicose veins/swelling, a small ankle cut can turn into a chronic ulcer. A cut near the ankle also sits over bone with very little soft tissue, so if the edges are gaping it may need suturing or skin closure strips within the first 24 hours.
Next Steps
1) Wash the wound gently with normal saline (or clean running water) - do not scrub, and avoid hydrogen peroxide or spirit directly in the wound as they damage healing tissue. 2) Pat dry, apply a thin layer of T-bact (mupirocin) ointment twice daily. 3) Cover with a sterile non-stick pad and light gauze/paper tape; change once daily, or sooner if it becomes wet or soiled. Do not wrap it tightly - circulation at the ankle is already reduced at his age. 4) No repeat TT needed if the December dose is documented and the wound is clean; if the wound was contaminated with soil, wood splinters or rust, or if you are unsure of the earlier dose, have him seen today so the doctor can decide about TT and immunoglobulin. 5) Ensure no wooden splinter is retained inside - if there is any doubt, it must be examined and cleaned, as a retained splinter guarantees infection. 6) Keep the leg elevated when sitting, encourage gentle walking, and check daily for spreading redness, swelling, pus or a foul smell. 7) Adequate protein, and if he is diabetic, keep sugars well controlled - both directly determine healing speed. 8) Get it reviewed in person if it has not shown clear improvement in 5-7 days, if it is more than about 1 cm deep or gaping, or at any sign of infection. 9) Also review why he hit the table - falls and furniture bumps at 87 warrant a check of vision, balance, BP and home safety. You are welcome to consult me on Practo with a photo of the wound, or in person at Synergy Multispeciality Hospital, Miraj.
Health Tips
Word of caution: seek medical care urgently if there is spreading redness or a red streak going up the leg, increasing pain, swelling, pus, foul smell, fever, blackening of the wound edges, numbness, or if he develops jaw stiffness, difficulty opening the mouth or muscle spasms. Avoid Neosporin if he has ever reacted to neomycin, do not apply turmeric, oils or powders to an open wound, and do not start oral antibiotics without a doctor's advice at his age.
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You can use t bact ointment or cream, tetanus toxoid injection iis not required at this time
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Kindly get assesed by a physician.
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Depends on depth and extent of wound. Please consult a physician physically.
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Depends on depth of the wound. If it is mild superficial cut then tbact is enough and can keep it open. If it is atleast above 1cm deep then clean wound with betadine solution or normal saline.wound should be closed with tbact application and with sterile guage piece. Unless there is fever or pus discharge don't start antibiotics. If pus or purulent discharge present then start tab taxim o 200 twice daily for 5 days. Tab dolo 650 sos. Tab limcee 500 twoce daily for 15 days.
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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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Tt no need.just wound hygiene requires.
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If he has taken the full course of tetanus in less than 5 yrs he need not repeat
Neosporin powder better
Clean well apply the antibiotic powder and dress it by bandaging
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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No tt required.
Locally good.
Orally
Zifi o200 two times after food for five days.
Zerodol sp three times a day after food for 3to5.
Montek lc one at night for 3to5 days.
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Mr. Rohan Gumber
General Physician
1 yrs exp
Sri Ganganagar
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Please consult
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Do connect and consult
Will help you
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you , kindly consult and provide detailed history for proper diagnosis and further management
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