THE INFECTED WOUND

The result of the intensive study of war wounds has been a better insight into the biology of infected wounds, which, in turn, has led to improvements in methods of treatment. Although most of the really important factors were known before the war, the great emergency brought them into practical general knowledge in a way that would otherwise have been impossible. For the first twelve to twenty-four hours following injury, the so-called preinflammatory stage, infecting organisms are confined to the surface of the wound. If, during this period, the wound surface can be excised (débridement), healing by primary intention is the rule and chemical treatment is useless at this stage. The importance of this phase of treatment has recently been emphasized by Duval,¹ who has shown that wounds of joints, once considered the most vulnerable of all tissues to infecting organisms, may be safely closed without drainage after débridement.