SURGICAL DRESSINGS OBSOLETE.

Star (Christchurch), Issue 11800, 11 September 1916, Page 6

SURGICAL DRESSINGS OBSOLETE.

LESSONS OF JUTLAND.

(By "Trio Times V Medical Correspondent.) From every great action the doctors who handle the wounded learn im- ; portant lessons. 'Die lesson of the | need of trench helmets is an example, | and so is the lesson of tho need of I anti-tetanic serum. It is now clear tliax the battle of .Jutland Bank has also taught its lessons. One hundred ami ten wounded men wero taken into the IJo.vni Naval Hospital at South j y.uconpforry, and the doctors in charge ' ot them have contributed to tho " Lancet ' an account of their wounds. They are clarified as follows:-- Shell wounds <i'2, hurus 4'J, mi fieri ng Irom tlie elfect of iume.s 4 and from severe shock ~. The small number of eases of shock is remarkable in view of the tremendous cmnoMde, which was a feature of the 1 battle, but, more remarkable still is the j fact that almost all the wounds were j septic, though less than forty-eight j .fiours Lad elapsed since the injuries were received. It was the custom earlier in the war to blame tho soil of France for the foarfullv septic wounds inflicted thorp. 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 the making of a ycry septic wound arc present on clothing and skin. Thero were many broken bones, and all the fractures were, compound. Amputation was often necessary. The chief concern, of trie surgeon was the prevention of sepsis, that is, of blood-poisoning. Two methods were adopted, representing what may be called the two great schools which have sprung up during the war-—the antiseptic school and the r-.slt solution school. The former is the school of Lister, .the latter the school of Sir Almroth Wright. It seems clear that, broadly speaking, Sir Almroth Wright's methods gave the most generally favourable results. "When once sepsis has gained a footing continuous saline 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 aipplication of antiseptics." This independent testimony from the 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 be gained by Avoiding "painful dressings" of wounds. Tho 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 ou in it; and it is costly. A surgeon of great experience stated in the writer's hearing a. few days ago: "I believe tvo shall outlive the dressing after all. 1 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 Almroth Wright is beautifully devised to afford every possible help to the healing wound. Some terrible cases of cordite burns were in the hospital at Queensferry. but recovered well. In speaking of the c e burns and their treatment, the authors say: "We on no account anplv a. dressing." These views,do not. of course, apply to field dressings, which are protective, hut to hospital treatment.