MARVELLOUS SURGERY.

North Otago Times, Volume CV, Issue 13857, 18 April 1917, Page 8

MARVELLOUS SURGERY.

HEALING WOUNDS BY IRRIGATION.

There is",a, groat hospital in Franco solely given over/to the treatment of wounded soldiers, There aro many such hospitals in .-France,in England, and crowded over the faco of Europe, but this 0110 hospital in Franco "is unique, for in it no man has yet died, from the effect of his wounds (Bays a London paper), The hospital is built at Compiegue, and was established after tho outbreak of war by the Rockefeller Research Institute for the purpose of testing a. new method,of hoaling deep wounds, devised by the famous French surgeon Dr Alexis Carrol, 'Before the war Dr Carrell wan probably best known to tho .general public as the man wiui grafted the leg of a black dog upon, tho body of a white dog 00 successfully that tho dog was able to scratch himself with tho claws of the : transplanted leg. The American Sunday papers hailed him becauso of some astonishing, experiments conducted in the rejuvenation of old dogs and cats. Scientists, of course, recognised that. Dr Carrel's "modern miracles" wero only picturesque incidents in an important investigation into human tissues,and thatrthe surgeon stood on the eve of a discovery that would be vastly mjre important to humanity than the accomplishment of gruesome tricks with cats and dogs. The war directed Dr Carrel's investigation into one particular channel, led to the discovery in the treatment of wounds of what is now known as tho "Methods do Irrigation Intermittent Carrel," and has givon the'hospital at. Compeigne its wonderful record of rapid and effective cures.

It took only a few months experience of war to show tho French surgeons that the greatest service that science could vender to the medical profession would be a cheap.,find thoroughly practicable method for the speedy sterilisation of deep wounds, an end towards which Lister started blazing the trail, but along which trail comparatively little progress had been made until a couple of years ago. Carrel, therefore, adopted better sterilisation, perfectsterilisation if humanly possible, as his line of endeavour. The Rockefeller Institute put its unlimited resources at his disposal, and this enabled the surgeon to elicit, the aid of the best special tlilent that the world, outside of the Central Powers, afforded.

It has generally been admitted that the difficulty in effecting a complete sterilisation of deep wounds in the past has been almost entirely on account of the trouble in reaching anything but the surface with the antiseptic. Br Carrel, at the outset, conceived the idea that, just as one washes a sponge by repeated saturations and wringings, so should a wound be washed by some sort of a "flushing" system that would send an antiseptic solution to every part of the wound. For this two things wore obviously necessaryfirst, a proper solution, and, second, a proper apparatus for applying or distributing it. The aid of the English chemist, Mr H, D. Dakin, was elicited in discovering the sojution, and after experiments with more than "00 mixtures the solution now in use—a onehall' of one per cent, solution of hypochlorite of soda, to which is added a small amount of boric acid—was decided upon. This is rerflly only n very pure oxygenated solution of common salt. A groat point in its favour is its negligible cost of three centimes per litre,

In experimenting with the apparatus Dr Carrel first made tests of allowing the liquid to fall upon the surface of the wound froni above, and then drawing it away through the action of a suction pump working on a number of perforated rubber tubes buried in the ilesh. Ultimately this plan gave wjijr to practically its reverse—that of carrying the solution to the -wound in perforated tubes buried in the flesh, and allowing it to drain away by gravity. By tiio system as finally perfected, and as at prcssent in use, the solution iss carried in a receptacle at the head nr the foul of the l«'d, ami once every Iwo hours., _bv opening a pinch cock nil the main rubber tube leading down to the wound, the latter is thoroughly ilushed with the liquid under a 4ft or lift pressure.

No sooner was the system put into regular operation tlian striking evidences of its 'efficacy were apparent, The daily microscopic examinations showed that the bacteria of infection | in wounds under treatment wore de- ' creasing at a rate never known before, I with the result that the actual healing of the wounds was accomplished in far Icbs time, often from a-half to ftthird, than they had required under ■the ordinary treatments. When the microscopic study showed the disap-. ppfirnnce of all traces of infection, it was found practicable to' close the wound,, either by stitching or witli adhesivo at once, The wound was as good as healed, .and with , the incalculable advantage over the old way of cicatrisation that the, area of still, useless scar tissue was reduced almost to nothing. Ninety per cent., and more of the area covered by the original wound was replaced by firm, pliable, serviceable flesh, . ' . Not - the. least important and interesting development' from the discovery, of the 'method Carrel" has been the mathematical working-out of a "law of cicatrisation." Dr Carrel.noted.that the rate of healing of a number of wounds as plotted on,the chart showed ' a remarkable regularity. The - assistancc of the .French physicist .and mathematician Dr Nouy was sought in establishing a formula, and, incredible as it may seem, the progress of patients in the Compeighe Hospital can now bo almost exactly calculated on a, graph,' and tho day of their cure- accurately predicted.'Dr Nouy obtained the ''lndex of Cicatrisation" by 'working it , out 'from'.tho* age of tho man and the' difference between the area of the wound on the first , day of treat/nent 1 and on the fourth. By plotting out , ''lines''of healing" for men of forty, ' thirty-two, thirty, twenty-live, andj twenty, years, it was-possible to obtain " "the index by simply drawing a liori- > zontal lino from \tlie, point' indicating I the size of tho wound in square ocnti-' : metres, to cut: the. curve;. of tho age of tlio patient,;mid idroppinj* a pcrpen;; dieular from to. the -base line. .Wlicirthe index was,obtajijed, all'that'' . was nocessary-was to put formula;- and work out .the result, wliieli was the nilmber of, days it'should take tho wound to heal under, tfoatmont by the, method ' jl'ho actual ,om. of wounds practically identical

fith. the theoretical' curVo< 111 „n.iticty nino cases out of a, hundred, The great practical value; of being able to.* .calculate :the curve of healing in advancers tho rstahdard: it sets: for the rate at which, tho wound ought tb close, Any sharj) deviation from tho curve indicates at onco that something is wrong. Incidentally, too, it enables the hospital authorities 'to figure weeks in advance the rate at which patients can be j-dis-charged, and at which beds will be vacant to receive new; ones'/ ■