A study of open joint injuries treated at the Los Angeles
County-University of Southern California Medical Center from July 1969
through July 1973 showed that the vast majority of these injuries were at
the knee. Three types of injury were identified: those associated with
fractures, injuries without fracture, and gunshot wounds. All patients
were treated with antibiotics, surgical debridement and irrigation, and
installation of polyethylene tubes into the joint as a system of
postoperative closed irrigation. The over-all infection rate was 2.1 per
cent. The results of treatment indicate that the irrigation system can be a
source of contamination. Our recommended treatment for open wounds in
joints is wide-spectrum systemic antibiotics, surgical debridement,
irrigation of the joint and soft tissues, and primary closure. Prolonged
suction-irrigation treatment postoperatively should only be done for
specific indications: excessive contamination or excessive tissue damage
when the wound to the joint should be closed primarily.