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Wound Contamination, Wound Infection, and the Antibiotics

AMA Arch Surg. 1957;75(5):706. doi:10.1001/archsurg.1957.01280170016006.
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In war and in peace, infection is the bête noire of the surgeon who handles wounds. The most vulnerable are the wounds of violence, especially when the tissue damage extends to muscle, bone, or one of the body cavities. All are contaminated, characteristically, with more than one species of pathogenic bacteria at the time of wounding or during exposure for treatment. The triad of infection which may result from these contaminations are tetanus, gas gangrene, and the pyogenic infections. The orbit around which all prophylactic measures evolve is operative handling of the wound, since no chemotherapeutic agent has yet been discovered which can, per se, sterilize a wound. Tetanus can almost always be prevented by immunotherapy, and gas gangrene, by timely and careful excisional surgery. Pyogenic infection is a consequence of septic decomposition of residual dead tissue bysecondary bacterial contaminants. often drug-resistant, and usually uninfluenced by systemic or topical antimicrobial


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