LOcal effects of antibacterial therapy (benzyl-penicillin) on missile wound infection rate and tissue devitalization when debridement is delayed for twelve hours.

Spherical steel bullets (0.88 g, 6.00 mm in diameter, impact velocity around 1000 m/s, smooth-bore rifle) were used for infliction of trauma to the thigh of pigs. The aim was to find out the effect of early antibiotic therapy (benzyl-penicillin) on wound infection rate and on the local progressive tissue devitalization when debridement was delayed until 12 hours after infliction of trauma. The main study on infection and tissue devitalization contained 20 missile wounds; the pilot study on cell metabolism 13 wounds. In the first group 11 pigs, and in the second group 7 pigs were treated with penicillin. Debridement was performed 12 hours after the infliction of trauma. Bacteriological analyses were done on tissue samples from the wound after pc treatment. The contents of adenosine triphosphate, creatine phosphate, glucose, glucose 6-phosphate and lactate were analysed in tissue samples from the wound with and without pc-treatment 12 h after trauma. The usual growth of bacteria when debridement was delayed for 12 h was totally inhibited by the early provision of penicillin. The amount of devitalized tissue-removed in relation to transferred energy was significantly reduced after the treatment as compared to the non-pc-group. The results of the studies on cell metabolism point to a graded tissue damage and possibly reversible injuries in the periphery of the wound, and to less metabolic disturbances after pc-treatment. The results indicated that early general supply of antibiotics may confine the local tissue injury when delayed debridement is anticipated.