Tetanus bacillus grows in soil and rust, so tetanus antitoxin should be injected when the wound is deeper and contaminated with soil or when it is stabbed by rusty iron.
You didn't describe the cut and its depth. If you have just a superficial cut from a non-rusty metal and the wound is not deep, you can skip the tetanus antitoxin injection as long as you do proper debridement. If you are really unsure, you can also go to the hospital for a tetanus antitoxin injection. This kind of injection is not expensive and shouldn't cost more than ten big bucks.
Because tetanus antitoxin is a kind of immune horse serum, it is a kind of heterogeneous protein to the human body, with antigenicity (allergic reaction), so make an allergy test before using the medicine. The test result is negative can be directly injected tetanus antitoxin, the test result is positive, then should be desensitized injection, that is, a small dose of tetanus antitoxin injection in 4 - 5 times. In the use of tetanus antitoxin more than a week, such as re-use, must also be re-tested skin.
The best time to inject tetanus antitoxin (TAT) is usually within 24 hours of the injury, and if you're not sure, it's OK to get a retroactive injection now, but I would think that after that long, your doctor would have warned you if the wound was infected enough at the time to warrant an injection of tetanus antitoxin.
I. Common complications of maxillary sinus puncture irrigation:
1. Fainting It is a momentary loss of consciousness that occurs when neuropsychiatric factors cause dysfunction of the reflex vasomotor center, resulting in cerebral anemia. Excessive mental tension, pain, weakness, hunger, fatigue, too much indoor water vapor, air circulation, etc., easy to occur. The authors believe that the rough language and behavior of health care workers, so that the patient loses trust, also has a certain relationship. Therefore, a detailed explanation should be given to the patient before puncture and the patient should be asked from time to time how he/she feels. Early symptoms of fainting are weakness, chest tightness, nausea, tinnitus, black haze, vertigo, unsteadiness in sitting, but it is too late to tell the doctor that the patient fainted and lost consciousness. Examination reveals a pale, sweaty face, shallow breathing, slow pulse, slightly low blood pressure, and in severe cases, unresponsiveness to stimuli and dilated pupils. This process is very short, about a few seconds to a few minutes, the patient gradually regain consciousness. Let the patient take the lying position or head down position, keep breathing, needle puncture Renzhong point, inhalation of oxygen, drink a cup of hot water, should not be further puncture.
2. Defecation is a manifestation of acute generalized vascular hypotonia and heart failure. It is easy to occur in chronic wasting disease, insufficient stress response and low secretion of epinephrine, pain and stress as its trigger. Symptoms are more severe than fainting, manifested by pale skin, cyanosis, weak and frequent pulse, shallow respiration, lowered blood pressure, lowered body temperature, hazy consciousness, and inability to recover quickly. Fainting is generally reversible, but can be life-threatening if not rescued in time. When maxillary sinus puncture is performed on bedridden patients, adequate preparation is needed, such as fluid infusion, correction of electrolyte disorders, and administration of hormones, and it is advisable to take the prone position for puncture, and attention should be paid to blood pressure, pulse and respiration for those who have already suffered from collapse, and 10% dextrose solution can be injected into the vein immediately for 40-60 ml.
3. Air embolism This complication is relatively rare, but it is a fatal danger. Because of the puncture needle into the vein of the mucosa of the maxillary sinus, and then forcefully injected air into the sinus after rinsing, in order to queue up the sinus left the liquid caused by. Air through the facial vein, internal jugular vein and to the right heart, or air bubbles upward into the medulla oblongata of the brain, embolism respiratory center and death. Patients can feel the sound of bubbles in the neck on the operative side during gas injection, followed by cyanosis, collapse, loss of consciousness, rapid respiratory and cardiac arrest and death. Resuscitation should quickly make the patient to take the head down position, lying on the left side, in order to avoid more bubbles into the brain, the left cardiac system and coronary arteries, artificial respiration, oxygen inhalation, ineffective need to carry out cardiac massage and cardiac puncture suction out of the heart in the gas.
4. Surface anesthetic allergic reaction The incidence is not high, but can be fatal. The performance of the central nervous system from top to bottom first excited and then paralyzed. Such as convulsions, spasms, breathing from irregular to stop, blood pressure drops, consciousness from excitement to loss, pupils from small to large. Resuscitation is appropriate with anti-spasmodic agents, artificial respiration and cardiac pacemaker.
II. Common complications of maxillary sinus fistula:
1. Nasolacrimal duct injury Long-term tearing on the affected side after surgery. Because the fistula position is too anterior, so in recent years some people advocate to change the fistula position in the middle of the lower nasal tract.
2. Nasal hemorrhage is due to the position of the fistula is too far back, damage to the nasal branch of the palatine artery, or too far forward, damage to the nasal branch of the upper lip artery.
3. Adhesion of inferior turbinate nasal septum Adhesion of inferior turbinate to the lateral wall of nasal cavity due to improper postoperative treatment.
III. Common complications of maxillary sinus radical surgery:
1. Postoperative hemorrhage According to domestic statistics, the incidence rate is 2.4% to 7%. Most of them occur within 24 hours after surgery. Bleeding in the small arteries at the edge of the window of the anterior wall of the maxillary sinus or at the edge of the foramen ovale can be caused by injury to the inferior turbinate, and can be stopped by compression; the bleeding that occurs afterward is secondary hemorrhage, which is often caused by the infection of the mucous membranes left in the sinus, and if the bleeding is more, the maxillary sinus can be probed from the original incision, and the bleeding mucous membranes can be removed and filled in, and the bleeding can be stopped.
2. Facial swelling This is a post-surgical reaction, mostly due to the use of a large number of high concentration of local anesthetic buccal submucosal injection, pulling the hook too hard and too long due to surgery. The treatment is to withdraw the sinus stuffing as soon as possible, apply hot compresses on the face, and apply antibiotics to prevent infection.
3. Numbness of the upper lip and upper teeth, mostly due to surgical incision damage to the infraorbital nerve, or due to the incision close to the midline, damage to the maxillary incisor nerve caused by a few months or a year to recover.