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December 1947


Author Affiliations

From the Department of Surgery of the University of Cincinnati College of Medicine and Cincinnati General Hospital. This paper is based in part on work done under grants from the National Institute of Health of the United States Public Health Service and the United States Army.

Arch Surg. 1947;55(6):668-680. doi:10.1001/archsurg.1947.01230080679004

CONFLICTING evidence obtained from numerous clinical and experimental reports has resulted in considerable confusion regarding the value and limitations of chemotherapy in gas gangrene. Although penicillin has been generally recognized as being more effective than the sulfonamide compounds, opinion is still divided as to its real value. Fisher and his associates,1 who had an opportunity to observe its influence on the incidence and course of gas gangrene in four hundred and thirty-six military wounds characterized by extensive laceration of muscle, compound fractures, arterial damage, gross contamination and many retained foreign bodies, concluded that the role of penicillin should be the prevention of gas gangrene rather than its treatment when already established. Jeffrey and Thomson2 enthusiastically recommended the parenteral administration of penicillin at the time of primary débridement and for the following three to five days. Among 28 patients with true gas gangrene who were treated in this manner

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