[Primary suture of older and contaminated wounds. A prospective clinical study]

In a prospective study of 50 consecutive patients primary wound closure was examined on cases with contaminated wounds. In 42 patients the period from the injury to the attendance of the ambulance ranged from 12 to 72 hours. Eight wounds were butcher's knife lesions in professionally exposed persons. Bacterial contamination could be demonstrated in 84% of the microbiologic smears. The principles of therapy were related to the wound care directions of Kirschner 1941 including a careful debridement. Routine administration of antibiotics was not necessary. Primary wound healing was achieved in 48 cases. Sutures were removed after 10.8 days, the time off work was 6.8 days. Wound infection occurred in 2 patients. After removing sutures undisturbed healing was observed in both cases. Due to these results we no longer see a contraindication in the primary closure of contaminated wounds. With careful debridement and conscientious wound control during the first 72 hours, primary suture is of low risk, comfortable to the patients and cost saving.