Wounds received outside of the operating room are contaminated wounds. They may be grossly clean or dirty, neat, or ragged, and contused (tidy or untidy in British parlence).

A "golden period" of approximately 6 hours was cited several decades ago as the optimal time during which to close a contaminated wound; if closure was not accomplished by 6 hours, the wound should be left open to prevent infection. This concept should not be entirely ignored, but more important is the answer to the question: Can this contaminated wound be converted into a surgically clean wound, or is this a contaminated wound in which bacterial activity is already so advanced that it cannot be converted?

We now have antibiotics and more refined surgical techniques, so given un excellent blood supply, we can take liberties with the golden period. A 2-day-old wound of the foot that shows no sign of infection can be closed with appropriate preparation (not simply "putting in stitches") with little risk of infection. A grossly clean, neat wrist laceration, 12 hours old, can be repuired safely. However, a 3-hour-old wound of the lower leg received from a dirty barnyard source should probably be left open.

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