Primary and Secondary Healing in Infected Wounds

Johnson, Brian W.

doi:10.1001/archsurg.1982.01380330047012

Cited by 17 publications

(4 citation statements)

References 10 publications

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“…Once dissected, the rectus muscle was closed with the experimental device on one side, whereas the other was closed with a control method. Each closure method comprised both a material (conventional suture in the control and the experimental device) and a technique intended to best utilize that material's mode of action 11–25…”

Section: Experimental Methodsmentioning

confidence: 99%

Fiber technology for reliable repair of skeletal muscle

et al. 2008

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Conventional soft-tissue reclosure methods-sutures and staples-require substantial organized-collagen content. Some tissues lack extensive intrinsic collagenous content. Wound disruption consequences range from newly closed abdominal wounds bursting open, to post-cesarean wombs splitting at delivery, to heart valves loosening. Although sutures do approach the theoretical limit of normal force transfer-cross-sectional area times compressive strength, a different paradigm-shear force transfer across the far greater surface attainable by fine fibers parallel to the potential disruptive force could exceed that theoretical limit. Capacity is now the product of frictional coefficient, existing tissue pressure, and contact area. Using a device comprising bundles of poly(ethylene terephthalate) fibers through tissue, we previously coupled muscles to devices and bones. Here we tested an analogous device for reclosing fascia-stripped abdominal wall muscles. In 28 rabbits, fascia-deprived rectus abdominus muscles were reclosed, using the experimental device or conventional sutures. Testing muscles from the 21 three-week survivors, (with closure devices retained-the usual clinical practice) demonstrated experimental failure strength which exceeded that of controls by 58%. Histologically, solid tissue elements did in-grow between fibers for an extensive tissue-prosthetic interface. Both histology and mechanical performance suggest the fiber technology presented herein surpasses conventional sutures in closure of collagen-deficient tissues.

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Section: Experimental Methodsmentioning

confidence: 99%

Fiber technology for reliable repair of skeletal muscle

et al. 2008

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“…High-pressure irrigation with a 35-mL syringe attached to a 19-gauge needle operated manually by one hand effectively decreases the level of bacterial contamination (40). The cleansing effect of the bulb syringe irrigation is negligible because the wound bacterial concentration is not significantly affected by this low-pressure irrigation sys- 46 R. F. Edlich et al…”

Section: Hair Removal Skin Disinfection Hemostasis Surgical Debridmentioning

confidence: 99%

“…The reparative process of open wounds associated with this developing resistance to infection in the open wound undergoing primary closure is associated with accelerated skin healing. In addition, Johnson and co-workers showed that secondary closure of the subcutaneous tissue and skin results in stronger fascial strength than that encountered after primary closure (46).…”

Section: Antibiotics Drains and Open Wound Managementmentioning

confidence: 99%

“…The occasional wound that is destined to develop infection after delayed closure can be identified with quantitative microbiology. When the bacterial count of the tissue is lower than 10 5 organisms/g of tissue, delayed closure can be accomplished without infection (46). After wound cleansing, the physical integrity and function of the injured tissue must be restored.…”

Section: Antibiotics Drains and Open Wound Managementmentioning

confidence: 99%

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