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Should my daughter be injected with tetvac?

Q: My 1.4 years old daughter had got the pulp of fingertip of right thumb detached after getting pressed by the hinge of wooden door. We took her to the emergency of a nearby hospital with the detached part in icy water. The wound was examined and an X-ray done. The detached part was stitched in its place. I was told that there is no injury to the bone or nail bed. I was also told to get the wound examined and dressed daily because if the detached part is found to be dead it had to be removed immediately. Then we took her to a plastic surgeon who told us that the wound should not be dressed. He prescribed an antibiotic, a painkiller – Ecosprine (20 mg). Please answer my following questions:-

  1. If I do not get the wound examined daily, can the dead part cause damage to the remaining finger?
  2. Is tetvac injection required.?
  3. What are the chances of the pulp getting attached?
  4. A:You should get the wound examined at least every alternate day. While missing a day in between will not cause harm, even if the detached part is becoming black, it is best to follow the advice of the doctor who has seen the wound. If your daughter is fully immunized, and I presume she is, she should not need tetvac. For small wounds tetvac does not need to be given more frequently than once in five years. However, since we don't take regular doses, doctors simply give a shot every time the patient gets a wound. Since your daughter is 1.4 years old, she has probably gone through the full immunization regime. A booster is not essential now, but there is no harm if she does get a booster. (If she has not been fully vaccinated in her first year of life, please do get full immunization!) The chance of successful healing of the detached part is about 30%, if it was completely detached. A lot depends on the degree of crushing that took place. What next? Just show to your doctor. If the part heals, fine. If it doesn't, the operated part will get infected. She will need regular dressings till all the infection is gone, and possibly later some small surgery. Contact a plastic surgeon or a hand specialist.

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