Emergency War Surgery NATO Handbook: Part II: Response of the Body to Wounding: Chapter XI: Infection

Bacteriology

United States Department of Defense

Bacterial contamination of a war wound is certain. The wounds are contaminated at the time of injury and secondary contamination may occur at any time during the course of treatment. Clostridium species are commonly introduced at the time of injury. Hemolytic Staphylococci and Streptococci may also be introduced at the time of wounding or by later contamination with such organisms in the hospital. Animal studies have shown heavy growth of Gram-positive cocci and Clostridium species in experimental missile wounds after delayed debridement. Gram-negative bacilli are typically encountered later and are often hospital acquired. Patients with abdominal injuries are also at risk of developing Gram-negative infection, particularly those with an injury to a hollow viscus. Many of these bacteria produce toxins and enzymes to facilitate their spread through tissues within wounds. Coagulase, fibrinolysin, proteinase, collagenase, and hyaluronidase favor the development and spread of wound infection.

The results of cultures taken from wound walls after debridement in animal studies indicate that, even though the degree of contamination or colonization can be significantly reduced by prompt debridement, the wound is not sterilized. Persistance of wound following mechanical cleansing and removal of damaged tissue justifies the use of prophylactic antibiotics.

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

Contact Us  ·  ·  Other Brookside Products