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PRIMARY AND DELAYED PRIMARY SUTURE IN THE TREATMENT OF WAR FRACTURES

WILLIAM S. BAER, M.D.
JAMA. 1918;70(21):1530-1533. doi:10.1001/jama.1918.26010210007008b.
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ABSTRACT

The treatment of fractures from battle casualties is for the most part the treatment of wounds of the soft parts, plus the added difficulties which the injuries to bony tissue involve.

To understand, therefore, the treatment of fractures, one must thoroughly appreciate the changes which have been made in the treatment of wounds of the soft parts.

American surgery is most fortunate in arriving on the scene when the principles of war surgery have been established. The biblical truths, as laid down by our French and English colleagues, have been founded on no uncertain grounds and have been enunciated in no uncertain terms.

These principles may be stated in this manner:

  1. All battle wounds are to be considered as infected.

  2. It is necessary to remove all projectiles, clothing and devitalized tissue as early as possible, at least before the twelfth hour after injury.

  3. These wounds can then be considered as

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