Pertinent factors influencing repair in traumatic wounds

An improved method of delayed primary closure. An aggressive management approach to unfavorable wounds

A technique of delayed primary closure is described that incorporates currently known principles of contaminated wound management. The technique utilizes periodic, aggressive wound debridement monitored by mapping of quantitative bacterial culture sites.

Quantitative bacterial analysis of comparative wound irrigations

It is a biologic fact that all open wounds contain bacteria and remain contaminated with varying levels of bacteria until successful wound closure has been accomplished. The sine qua non in the management of the contaminated wound has been and remains adequate sharp debridement. In a standardized experimental model, three methods of irrigation were compared employing quantitative bacteriology of tissue to evaluate their effectiveness at decreasing bacterial levels and reducing wound infection. The pulsating jet lavate was found to be significantly better than gravity flow irrigation or wound irrigation with a bulb syringe. These data on tissue biopsies support previous reports using surface and wound exudate cultures.