WOUND-HEALING IN COMPOUND FRACTURES AND REPAIR OF BONE DEFECTS

¹ Medical Corps, Army of the United States

Penicillin has been used clinically and found to be effective in controlling most wound infections associated with compound fracture, when used in full doses as an adjunct to a well-rounded surgical program. As an effective dose, 200,000 units per day, given by the intramuscular route, in 25,000-unit doses every three hours each twenty-four hours, is recommended. Since most patients with septic compound fractures require operative procedures, the "unsteady state" described by Lyons must be corrected rapidly, and whole blood and plasma are the only agents which quickly accomplish this. High-protein, high-caloric diet is used for adequate supply of proteins needed for the repair of tissue. Wound-healing is most satisfactorily effected under a combination of good surgical care—including operation with the patient supported by blood and plasma therapy—adequate diet, and control of infection by penicillin therapy. With the patient in good condition, and with the use of penicillin in the prevention of infection, reconstructive surgery can be performed at a shorter interval of time after complete wound-healing than was formerly considered safe.

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