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A two-stage method of treatment of open injuries of the extremities is described consisting
of primary surgical toilet of the skin and excision of the wound, leaving the wound
itself open and covered with a dressing moistened with 0·005 per cent cetrimide. The
dressing is changed daily. Within a few days the definitive treatment is undertaken
with further excision and repair of severed tendons and nerves. Skin closure is obtained
by suture or graft.
The results of this treatment in 881 cases is reported. Eight hundred and forty-one
wounds healed without infection, 15 cases had small stitch abscesses or slight transitory
erythema, and definite infection of the wound occurred in 25 cases. This amounts to
a total of 2·8 per cent compared with 4·9 per cent of infections occurring in a series
of 283 cases treated by primary suture.
This method is considered satisfactory because there are relatively few cases of infection
and as it allows early repair of divided tendons and nerves at a time when the patient
is well prepared and operating conditions are at their best.
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© 1970 Published by Elsevier Inc.
