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In regard to tuberculosis of bones and joints (see preceding numbers of The Journal) Volkmann goes on to say:27. Wounds from operations on joints and bones often become tuberculous before perfect healing is accomplished; fistulas and drainage openings fill with fungous granulations, parts of the wound already healed re-open, and new tuberculous abscesses form. In such cases very energetic treatment is to be recommended; renewed scraping out, cauterization with the thermo-cautery, wide incisions, and particularly tamponning of the open, perfectly cleansed wound with antiseptic gauze (particularly iodoform and sublimate gauze). The last measure is probably the most effective, and in the most severe cases should not infrequently be put in practice immediately after the first operation. But I do not consider it advisable to carry the principle of open-treatment of wounds too far, since we often get primary union after these operations.The main thing, however, is
MEDICAL PROGRESS.. JAMA. 1887;IX(23):717–720. doi:10.1001/jama.1887.02400220013002
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