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August 4, 1945

EARLY HEALING IN CHRONIC OSTEOMYELITIS AND COMPOUND FRACTURES

JAMA. 1945;128(14):1045. doi:10.1001/jama.1945.02860310059022

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Abstract

To the Editor:—  Those who are familiar with the surgical program that I have been advocating for many years will remember that I insist on early correct position for inflamed or injured parts, adequate surgical drainage by clean-up of contaminated or inflamed areas (débridement), wide open wounds to provide adequate drainage, prolonged immobilization in correct position, and protection of the wound surface against secondary infection. There must be the same kind of protection (usually by infrequent dressings) until there is sound healing, in the best position for physiologic function in the extremity, and for use of the limb after the patient's recovery.In dealing with the wound and the wound surface, suturing of the wound should not be done in such a way as to cover up contaminated or septic areas (and thus pockets of infection) during or after wound healing. Efforts at primary and secondary suture, such as are

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