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June 4, 1960


Author Affiliations


From the Department of Surgery, University of Cincinnati College of Medicine and the Cincinnati General Hospital.

JAMA. 1960;173(5):527-533. doi:10.1001/jama.1960.73020230026008d

It is a well-established fact that hemorrhage, shock, impairment of respiration, and infection are the complications most dreaded in injured patients.1 Wounds of violence are particularly prone to develop infection because of their gross contamination, the presence of large areas of devitalized tissue and retained foreign bodies (fig. 1), the involvement of regions particularly susceptible to infection, the frequent association of vascular injuries, and delayed or faulty surgical therapy.2 The development of infection in wounds increases the period of morbidity, produces further destruction of tissue, suppresses the process of healing, and may have a significant effect on mortality.3 Tissues destroyed by bacterial invasion are usually replaced by scar tissue which may affect function as well as cosmetic appearance.

General Considerations  Unfortunately, infection, the greatest enemy of wound healing, continues to be a serious problem, aseptic technique and antibiotic therapy notwithstanding. The primary basis of this form of