The Classic - The Effect Of Wound Environment On The Incidence Of Acute Osteomyelitis (Reprinted From Clin Orthop Relat Res, Vol 286, Pg 289-297, 1993)

Twelve years ago Dr. Carl Nelson (Fig 1) published the accompanying Classic Article, The Effect of Wound Environment on the Incidence of Bone Infection. In his experiments he found that the virulence of bacteria placed locally at an injury site affected the incidence of infection adversely but that the effect surprisingly was relatively minor. Placing dead autologous bone in the wound site, however, had a profound effect on the incidence of osteomyelitis. Ninety-three percent of the test animals developed osteomyelitis when dead bone was placed in a wound contaminated with virulent micro-organisms whereas only 17% of test animals developed osteomyelitis when only virulent organisms without the dead bone were used. One hundred percent of test animals developed osteomyelitis when the virulent organisms and dead bone and metal internal fixation were combined. Dr. Nelson's animal model in this experiment was used for many years in many other experiments involving treatment and manipulation of bacteria.Carl Nelson spent much of his working life in Little Rock where he served as Chairman of the Department of Orthopaedic Surgery of the University of Arkansas Medical School. He graduated from Purdue University in 1955, from Indiana University in 1955, and from Indiana University School of Medicine in 1959. He completed an orthopaedic residency at the Cleveland Clinic and served as a Nuffield Scholar at the Nuffield Orthopaedic Center at Oxford, England from 1968 to 1969. He published hundreds of papers and educated numerous orthopaedic residents during his time at the University of Arkansas. He had a profound interest in the prevention and treatment of musculoskeletal infections and many of his contributions to the orthopaedic literature relate to these issues. He served as the president of the Musculoskeletal Infection Society in 1995 and was the winner of the Jeanette Wilkins award given by the MSIS in recognition of his work.