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July 1969

Systemic Antibiotic(s) in Contaminated Crush WoundWithout Debridement

Author Affiliations

Washington, DC
From the Division of Surgery, Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Washington, DC.

Arch Surg. 1969;99(1):103-106. doi:10.1001/archsurg.1969.01340130105021

A most important step in the treatment of massive and open wounds received under combat or similar conditions is adequate and timely debridement. Unfortunately, under certain military or mass casualty conditions, debridement may be delayed for hours or even days. Such delays result in infected wounds containing nonvital tissue. Topical application of adequate doses of oxytetracycline or a mixture of polymyxin B sulfate, neomycin sulfate, and zinc bacitracin dispersed in inert propellent (Neosporin Aerosol) from individually disposable spray units to large contaminated crush wounds of the thighs of experimental animals was evaluated at this Institute. The spray reduced mortality from 64% in the control group to 4% in this experiment if the wounds were sprayed within five minutes after injury.

This communication presents the results of studies demonstrating the efficacy of systemic antibiotics in preventing infection in experimentally produced and contaminated crush wounds which were not debrided.

Materials and Methods 

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