Principles of traumatic surgery.1942

Traumatic surgery is emergency surgery and the fundamental thing is "to do it now." The 6-hour period is the Golden Period. If we can take care of our wounds during that time we are very much less likely to get infections. After the 6-hour period there is a different type of treatment because the situation is different. Let us debride our wounds; let us use the sulfa drug on the outside as well as internally; but do not regard them as substitutes for the ordinary surgery asepsis of years back. In the infected cases, sulfa drugs are invaluable, but don't rely on sulfa drugs to carry you through; the sulfa drugs won't do it without giving the wound ordinary cleansing; and don't forget that the sulfa drugs are specific for infections of the erysipelas type and other cellulitis. Do not sew up a debrided case, and above all, do not sew it up in a compound fracture. In infections there are 3 indications for incision: local fluctuation, localized tenderness and local induration. Never for brawny induration; never for adenitis.