THE TREATMENT OF INFECTED SUPPURATING WAR WOUNDS

Louisa Garrett Anderson
1916 The Lancet  
kind enough to send us his formula and to suggest that the staff of this hospital might find the method of treatment useful and conservative. Acting on his advice, and encouraged by the results which we obtained, we have employed it in an increasing number of cases. Our experience extends over a period of eight weeks, and includes approximately 200 cases ; our results have been similar to those obtained in the Northumberland War Hospital. The kind of wounds in which the
more » ... paste has been used by us includes compound fractures of the humerus and femur, severe gunshot wounds of the foot and hand, gangrenous and septic wounds of the muscular tissues, abscesses, one cerebral hernia, and gunshot wounds of knee, hip, and shoulder-joints. In every case fcetor has disappeared, sepsis has subsided, and union of bone has taken place with astonishing rapidity, while the condition of the patient has benefited greatly from being spared painful daily dressings. In support of our observation I beg to quote a few cases :— 1. Corporal -, aged 39. 1/7/16: Wounded. 7/7,'16: Admitted with gunshot wound right hand, two septic irregular wounds which had been enlarged in France, a tube being passed from one to the other; fracture of the styloid process of ulna, pisiform, unciform, os magnum, and base of fifth metacarpal bones. His hand was dressed with " Bipp " on 9/7/16; dressings renewed weekly. 8/8/16 : Healed. Callus has formed; he has some movement in the wrist, and his grasp is good and still improving. 2. Private -. 1/7/16: Wounded. 6/7/16 : Admitted with comminuted compound fracture of the ulna and laceration of the tissues of the forearm. 14/7/16: Operation; bullet removed, damaged tissue excised, methylated spirit and "Bipp" applied. Dressed at intervals of four to eight days. 12/8/16: Fracture united and wound superficial. 23/8/16: Movements forearm restored. 3. Private -. 1/7/16 : Wounded. 6/7/16 : Admitted with compound, comminuted and very septic fracture of foot. Three metatarsals were splintered and the tarsus involved. The foot was so septic and painful and the general condition of the man was so bad that amputation seemed inevitable. 8/7/16: Operation ; excision of damaged tissues and cleansing with gauze soaked in methylated spirit and tincture of iodine followed by packing with "Bipp." Dressed at intervals of four to eight days. 20/8/16: Wound healed except for an abrasion on the dorsum. Movements restored. 4. Corporal -. 27/7/16 : Wounded. 2/8/16: Admitted with compound fracture of centre of shaft of humerus communicating with huge flesh wounds involving the outer, inner, and under surfaces of the arm. 3/8/16: Operation ; sloughs and loose bone removed, cleaned, and "Bipp" " applied. Dressed at intervals of three to five days. 24/8/16 : Fracture uniting. Wounds rapidly healing and quite clean. (Three weeks.) 5. Private ——. 1/7/16 : Wounded. 6/7/16: Admitted with compound fracture of femur with 1 inch shortening and septic wounds of the outer and inner surfaces of the thigh communicating with the bone. 12/7/16: Operation, cleaning withtinctureof iodine, rectified spirit, and " Bipp." Wounds closed by interrupted silk-worm sutures. Interrupted long Liston splint, and 151b. weight of extension applied. 15/7/16 : Stitches removed; "Bipp" " applied superficially. Spirit gauze to wound at intervals of four to eight days. 20/8/16: Fracture uniting. No shortening. Wound practically healed. 6. Lance-Corporal -. 27/7/16: Showed signs of calculus pyelitis. 5/8/16 : Operation, evacuation of pus round kidney and nephrectomy. Cavity dried. "Bipp and light gauze packing inserted. Dressed daily for first week, the cavity being wiped out with gauze and small quantities of " Bipp " inserted. Since then dressed on alternate days. Wound almost superficial, no sepsis since operation. In only one case have ill-effects been observed. The patient was admitted after an amputation through the thigh with a protruding bone and sloughing stump and in a very toxic condition. The stump cleaned up under treatment with " Bipp " and the temperature subsided. The intermuscular tracts were packed with gauze soaked in " I Bipp. ".4 The temperature rose ; the man suffered from delirium and wasting and excreted large quantities of potassium iodide. When the treatment was changed his temperature becamenormal and he is making a good recovery. We are greatly indebted to Professor Rutherford Morison for this remedy. It saves the patients a great deal of'pain and exhaustion and the results are incomparably better than any which we have obtained by other methods. I am, Sir, yours faithfully,
doi:10.1016/s0140-6736(00)58960-0 fatcat:kbgc6hsyrbashljcwxyr2p5qya