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Article
April 17, 1954

FUNDAMENTALS OF SURGERY IN CONTAMINATED AND INFECTED WOUNDS

Author Affiliations

St. Louis

From the Department of Surgery, Washington University Medical School.

JAMA. 1954;154(16):1326-1328. doi:10.1001/jama.1954.02940500006002
Abstract

The basic objectives of wound management are to prevent or cut short infection in contaminated wounds, to eliminate the septic process in already infected and suppurating wounds, and, in each, to obtain sound healing. Surgical treatment of such wounds is designed to achieve these objectives with a maximum preservation of tissue, a minimum of scar, and a maximum return of function of the part in a minimum of time. Wound infection may be classified on a clinical basis as invasive infection, wound suppuration, or surface infection.

Invasive infection is characterized by bacterial invasion and destruction of living tissue. Typical examples are hemolytic streptococcic infections and true gas gangrene. In anaerobic invasive infection, bacteria such as Clostridia, capable of causing gas gangrene, or hemolytic cocci in symbiosis with facultative anaerobes, take hold in devitalized tissue and then proceed to invade and kill living tissue. Even aerobic invasive infection is more likely

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