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LOCAL APPLICATION OF SULFONAMIDES TO SYNOVIAL SURFACES
Edgar M. Bick; Homer C. Pheasant
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Station Hospital, Fart Monmouth
1942 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1942; 24:937-939 
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Abstract

1. Topical application of sulfonamide derivatives to the deep tissues in traumatic wounds or surgical incisions, avoiding the skin and the immediate subcutaneous areas, have been just as effective in preventing infection as when sprayed or otherwise spread over the entire wound area. This has been specifically observed in applications to the articular, tendonsheath, and bursal-synovial tissue.

2. In general, far smaller doses than are usually recommended have been found adequate, and do not significantly retard healing.

3. Sulfonamide derivatives can be applied safely to synovial tissues of joint cavities and bursae or tendon sheaths. When reasonably small quantities are used, no residual adhesions, fibrosis, or other alterations occur, which are not found in similar lesions treated without these drugs.

4. In topical applications to joints or other synovial surfaces, sulfanilamide and sulfathiazole are entirely effective, and can be used interchangeably. Sulfanilamide, because of its smoother handling and greater local staying power, is recommended as the sulfonamide of choice.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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