Why should there be many varied opinions among medical men as to what constitutes the most adequate and effective treatment of a compound injury, whether it involves the hand or some other part of the body? Much of this difference of opinion is due to the fact that we have often lost sight of basic surgical principles and concentrated our attention on details of treatment. In ignoring principles we have sometimes been led to utilize methods which retarded or actually defeated the recovery we desired to hasten.
What are these surgical principles which form the basis of logical treatment?
1. The first law of surgery: nihil nocere—to do no harm.
2. Not to leave contaminated tissue in the injured area.
3. To avoid, so far as possible, leaving foreign bodies buried in the tissues.
4. To close every open wound as soon as it can be done with safety.
KOCH SL. INJURIES OF THE HAND: CLINICAL LECTURE AT KANSAS CITY SESSION. JAMA. 1936;107(13):1044–1049. doi:10.1001/jama.1936.92770390005011
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