The enzyme-linked immunosorbent assay (ELISA) was used for the detection of circulating antibodies in human sera to antigens of three serotypes of Treponema denticola. The antigens used in the assay were obtained by a sodium deoxycholate extraction procedure. Sera obtained from totally edentulous patients, patients with advanced periodontitis, as well as dental students who were in good to excellent periodontal health were tested for antibodies to these antigens by ELISA. Significantly elevated antibody levels were detected in iO/U patients with advanced periodontitis towards the antigens of all 3 serotypes. In contrast, 11/ 13 edentulous patients were negative for antibodies to serotypes W and TT and 9/13 were negative against serotype 11. In the mild gingival inflammation group, 11/14 individuals were negative against serotypes W and 11, and all were found to be negative against serotype TT. Adsorption studies carried out with 4 highly reactive sera indicated that the IgG antibodies detected by ELISA were specific for these antigens of T. denticola. The results of these studies are at variance with those of previous investigators who reported the total absence of detectable antibodies to T. denticola in sera from patients with advanced periodontal disease.
A retrospective analysis was conducted of 37 open fracture cases sustained by U.S. military personnel during the recent low-intensity conflict in Panama (Operation Just Cause). The etiology, location, classification, and management of open fractures sustained in combat is presented. A significant difference was noted in the infection rate for type III open fractures that were debrided in Panama (22%) as compared to those that were debrided only after transport to CONUS (66%). This study supports the critical importance of adequate battlefield surgical support in low-intensity conflicts, and reemphasizes the crucial role of early surgical debridement for the prevention of wound infection.
War wounds are characterized by devitalized tissue, the presence of debris, and contamination by bacteria--factors that contribute to the establishment of wound infection. A review of the literature regarding the incidence of wound infection in recent military conflicts strongly suggests that infection in open war wounds occurs with relative frequency despite strict adherence to the principles of surgical debridement and administration of "prophylactic" antibiotics. Further research leading to improved methods of preventing wound sepsis is warranted in order to reduce the incidence of wound infections in the future.
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