title: The early management of open joint injuries. A prospective study of one hundred and forty patients.
abstract: A study of open joint injuries treated at the Los Angeles County-University of Southern California Medical Center from July 1969 through July 1973 showed that the vast majority of these injuries were at the knee. Three types of injury were identified: those associated with fractures, injuries without fracture, and gunshot  wounds. All patients were treated with antibiotics, surgical débridement and irrigation, and installation of polyethylene tubes into the joint as a system of postoperative closed irrigation. The over-all infection rate was 2.1 per cent. The results of treatment indicate that the irrigation system can be a source of contamination. Our recommended treatment for open wounds in joints is wide-spectrum systemic antibiotics, surgical débridement, irrigation of the joint and soft tissues, and primary closure. Prolonged suction-irrigation treatment postoperatively should only be done for specific indications: excessive contamination or excessive tissue damage when the wound to the joint should be closed primarily.
mesh_terms: D000328:Adult; D000368:Aged; D016512:Ankle Injuries; D004322:Drainage; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D050723:Fractures, Bone / Q000601:surgery; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D007596:Joints / Q000293:injuries*; D007710:Klebsiella Infections / Q000188:drug therapy; D007718:Knee Injuries; D008297:Male; D008712:Methicillin / Q000627:therapeutic use; D008875:Middle Aged; D010329:Patella / Q000293:injuries; D011552:Pseudomonas Infections / Q000188:drug therapy; D007507:Therapeutic Irrigation; D014946:Wound Infection / Q000188:drug therapy; D014948:Wounds, Gunshot / Q000601:surgery
chemical_list: D005839:Gentamicins; D008712:Methicillin