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SECONDARY CLOSURE OF WOUNDS ASSOCIATED WITH COMPOUND FRACTURES
JAMES O. BARR
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Medical Corps, Army of the United States
1947 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1947; 29:376-380 
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Abstract

1. Chemotherapy is probably of little or no benefit during time actual process of closing wounds associated with compound fractures.

2. It is quite conclusive that, the better the blood picture, the better chance a patient has for his wounds to heal.

3. It is believed that the age of the wound, in itself, has no particular significance with relation to whether or not the wound remains healed.

4. The anatomical location of a wound is time most important factor both in the initial closure of the wound and in the final result after the wound has been closed. Wounds in the leg, particularly time lower third of the leg and around time ankle and foot, present the greatest number of partial and complete breakdowns.

5. The type of wound discharge is probably not of great importance in the prognosis of secondary closures. Those wounds which present a seropurulent or purulent discharge do not heal so satisfactorily as those presenting a serous or serosanguineous discharge.

6. No one factor alone can be cited as being of prime importance in breakdowns. However, the combination of anatomical location of the wound, the general physical condition of time patient on admission, and the type of wound discharge have been shown to be of the utmost importance in the final outcome of these wounds.

7. The occurrence of diffuse osteoniyelitis after the closing of compound fractures is not to be feared, and the benefit derived from closing the wounds far outweighs the slight (0.5 per cent.) chance one takes of diffuse osteomyelitis.

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    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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