Emergency War Surgery NATO Handbook: Part III: General Considerations of Wound Management: Chapter XIX: Wounds and Injuries of Bones and Joints
United States Department of Defense
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Early medical evacuation from the battlefield provides access to the casualty before frank infection has developed. However, if the tactical situation is such that infection has already occurred, emergency operation is still indicated. Wide exposure is accomplished for excision of devitalized tissue, removal of foreign bodies, and drainage of purulent material. The wound is irrigated copiously, and systemic broadspectrum antibiotics are utilized until an infecting organism has been identified and sensitivities determined. The use of suction irrigation as a technique in infected fractures and septic joints is somewhat controversial. Caution must be used to avoid systemic toxicity when continuous antibiotic irrigation is employed.
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