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Article
December 1940

RECURRENCE OF INFECTION AFTER ELECTIVE OPERATIONS IN CASES OF HEALED SUPPURATION IN BONES AND JOINTS

Author Affiliations

PORTLAND, ORE.
From the Department of Orthopedic Surgery (service of Dr. A. Steindler), the State University of Iowa Hospitals.

Arch Surg. 1940;41(6):1426-1436. doi:10.1001/archsurg.1940.01210060123011
Abstract

Elective operative procedures in cases of healed suppuration in bones and joints are frequent in the practice of the orthopedic surgeon. The frequency with which osteomyelitis or suppurative arthritis recurs as a result of common, everyday trauma is only too well known. Operative trauma, such as that associated with arthrodesis, arthroplasty or osteotomy, is little different from closed external trauma. One should, therefore, expect some recurrence of infection in healed suppurative lesions of bones and joints in the event of operation. Actually, such recurrent infection has been observed for a number of years, and the frequency with which suppuration recurs was the impetus for this analysis. According to Wilensky,1 destruction of trabeculae and subsequent hemorrhagic exudate result in an area of decreased resistance that can readily become infected with any available bacteria. The latency of osseous infection is a common disturbing factor, and there are frequently available bacteria in

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