SURGICAL DRESSINGS OBSOLETE

Dominion, Volume 9, Issue 2870, 7 September 1916, Page 6

SURGICAL DRESSINGS OBSOLETE

LESSONS OF JUTLAND (By "The Times'" Medical Correspondent.) From every great action the doctors who handlo the wounded learn important lessons. ' Tho lesson of the need of trench helmets is an example, and so is tho lesson of the need of anti-tetanic serum. 'It is now clear that the Battle of Jutland Bank has also taught its lessons. One hundred and ten wounded men were taken into the Royal Naval Hospital at South Queensferry, and tho doctors in charge of them have contributed to tho "Lancet" an account of their wounds. They are classified as follows: —Shell wounds 62, burns 42, suffering from the effect of fumes A, and from severe shook 2. The small number of cases of shock is remarkable in view of tho tremendous cannonade, whiqji was a feature o? the battle, but more remarkable ■ still is tho fact that almost all the wounds were septic, though less than 48 hours had elapsed since the injuries were received. It was the custom earlier in tho. war to blame the soil of France for the fearfully septic wounds inflicted there. Clearly we shall require to revise this opinion, for it is notorious that bacterial life scarcely exists on the sea. ■ Evidently all the elements necessary 'to tho making • of a very scptio wound are present on clothing and skin. There were many broken bones, 'and all the fractures were compound. Amputation was often necessary. ■ The chief concern of the surgeon was the prevention of sepsis, that is, of bloodpoisoning. Two methods were adopted, representing what may be called the two great _ schools which have sprung up during tho war—tho antiseptic school and the salt solution school. The former is the school of Lister, the latter the school of Sit Almroth Wright. It seems clear that, broadly speaking, Sir Aimroth Wright's methods gave the most geni erally favourable results. "When onco sepsis has gainod a footing continuous salino irrigation seems to meet the requirements, does away with painful dressings, and is particularly nonirritating to the injured and exposed periosteum (sheath of the bone), which is so easily, destroyed by the application of antisoptics."- This independent testimony from tho Navy to the'great work of Colonel Sir'Almroth Wright is of deep interest. '

The greatest of these changes finds. expression in certain allusions to the advantages to bo gained by avoiding "painful dressings"' of wounds. The battle of Jutland Bank thus emphasises a truth that has been plain to "many doctors since Sir Almroth Wright began his -work on the healing of wounds, namely, that the surgical dressing— lint bandage and wool—is out of date. It has been found out. It is a barrier to the free discharge of lymph which cleans the wound; it forms a breeding ground of germs; it sticks to the wound and dries on, and its removal is attended by great pain, and often danger from bleeding; finally, it hurts the wound and is apt to destroy delicate healing processes going on in it; and it is costly. ■ A surgeon of great experience stated in the writer's hearing a, few days ago>: "I believe we shall outlive the dressing after all. I used to think that idea was Utopian, but the war has opened men's eyes/' -: •

The'method of "irrigation" by saline solutions as suggested by Sir Alinrotli -Wright is beautifully devised to afford ovory possible ; help to ,1116 healing wound. Some terrible cases of cordite burn's were in the hospital at Queensferry, but recovered well. In speaking of these burns and their treatment, tne authors say: "We on no account apply a dressing." These views do not, of course, apply to field dressings, which aTO. protective, but to hospital treatment. '