Long-term recovery from tetanus: a study of 50 survivors.

A follow-up study of 50 patients treated in the tetanus unit of the General Infirmary at Leeds from 1961 to 1977 showed that 29 patients had regained normal health, nine were still improving, but 12 considered that their health had been permanently impaired. In only two of these 12, however, was the deterioration serious and unequivocally linked to their illness and treatment. All but five of those previously working had returned to full employment. Sixteen patients had unpleasant memories of the illness and treatment, 19 had psychological after effects, and one suffered serious damage to mental function. Little evidence was found of pulmonary dysfunction after the disease and its treatment, and although all the patients showed a tracheal stricture of some degree, few had directly associated disabilities. The cause of stricture is multifactorial, the surgical technique being only one. A formal surgical closure of the trachea (if a flap has been used) and of the tissue of the neck in layers should lessen residual disability from the scar and strictured areas.