Studies in the management of the contaminated wound. VI. The therapeutic

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value of gentle scrubbing in prolonging the limited period of effectiveness of antibiotics in contaminated wounds. Edlich RF. Madden JE. Prusak M. Panek P. Thul J. Wangensteen OH. American Journal of Surgery. [JC:3z4] 121(6):668-72, 1971 Jun. - effective period of action of topical and systemic antibiotics is sig greater in contaminated wounds closed primarily than in wounds under- going a delayed closure; - the beneficial effects of antibiotics were apparent in the primarily closed wounds for 48 hrs; - the effectiveness of systemic antibiotics in preventing wound infection was significantly greater in wounds closed primarily than in wounds undergoing secondary closure; - when the treatment of open contaminated wounds was delayed for 3 hrs or more, antibiotics had no apparrent therapeutic value; - by 24 hrs, post wounding all contaiminated wounds were infected despite antibiotic treatment; - the ineffectiveness of antibiotics in open wounds was attributed to a rapidly developing coagulum which may limit the drug's access to the organism; - the therapeutic potential of antibiotics in contaminated open wounds was enhance by swabbing the wound with a gauze sponge at the time of administration of the drug; - utilizing this adjuct, the limited period of systemic and topical antibiotic action in contaminated wounds undergoing DPC was prolonged; - perhaps the scrubbing mechanically cleansed the wound by removing bacteria and or disrupted the coagulum covering the contaiminated wound, allowing the drug more intimate contact with the bacteria;