1. The evidence presented does not prove definitely that sulfanilamide either is or is not a preventive of infection in compound fractures. More definite conclusions can be reached only by a comparative analysis of at least 200 cases with a control group of an equal number of analogous cases from past records.
2. Primary healing of mild fresh compound fractures obviously should be disregarded as evidence of any favorable action of sulfanilamide. In the severe and moderate types of compound fractures reported herein, certainly better anatomical and functional results were secured by internal fixation in conjunction with sulfanilamide, without higher proportions of complications, than developed in comparable control groups wherein internal fixation and sulfanilamide were not employed.
3. In seven consecutive cases with potential infection following compound fractures, extensive surgery was followed by more complete restoration of anatomical contour, without relighting of infection, than had been possible in the past.
4. The beneficial influence of this drug was most striking in the group of actively infected fractures in which radical surgery had previously led to disaster.
5. Far too many premature conclusions regarding the beneficial action of bactericidal agents are to be found in the literature. The present impression of sulfanilamide is favorable, but more extensive investigation must be carried out, not only with sulfanilamide, but with other chemotherapeutic agents, before an accurate evaluation is possible.
(C) 1940 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.