HEALING WOUNDS BY “IRRIGATION”

Dominion, Volume 10, Issue 3059, 21 April 1917, Page 6

HEALING WOUNDS BY “IRRIGATION”

MARVELLOUS SURGERY IN FRANCE CARREL'S TRIUMPHS There is a great hospital in France solely given over to the treatment of wounded soldiers. There are many such hospitals in France, in England, and crowdcd over the .face of Europe, but ■ this one hospital in France is unique, for in it 110 man has yet died from the effect of his .wounds. The hospital is built at Compicgne, and was established after the outbreak of war by the Kockfeller Research Institute for the purpose of testing a new method of healing deep wounds, devised by the famous Fronch surgeon Dr. Alexis Carrel. Before the war Dr. Carrel was probably best known to the general public as the man who grafted the leg of a black dog upon the body of a white dog so successfully that the dog was able to scratch himself with the claws of the transplanted leg. The American Sunday papers hailed him because of some astonishing experiments conducted in the rejuvenation of old dogs and cats. Scientists recognised, of course, that Dr. Carrol's "modern were only picturesque incidents in an important investigation into human tissues, and that tho surgeon stood on the ov* of a discovery that would be vastly more 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 the "Methods de Irrigation Intermittent Carrel," and has given the hospital at Cotnpiogno its wonderful record of rapid and effective cures. "Deep" Wounds.'' It took only a few months' experience of war to show the French surgeons that the greatest service that scicnce could render to the medical profession would be a cheap and thoroughly practicable method for the speedy sterilisation of deep wounds, an end towards which Lister started' blazing tho trail, but along which trail comparatively little progress had been made until a couple of years ago. Carrel therefore adopted better sterilisation, perfect sterilisation if humanly possible, as his line of endeavour. Tho Rockefeller Institute put its unlimited resources at his disposal, and this enabled the surgeon to elicit the aid cf the best talent that tho world, outside of. tlio Central Powers, afforded. It has generally been admitted tlmt the difficulty in effecting a complete sterilisation of deep wounds in the past has been almost entirely on account of tho trouble in reaching anything but the surface with tho antiseptic. Dr.

Carrel at tlio outset co: .iivfid the idea that, just as one washes a sponge by repeated saturations aud wringings, so should a wound to washed by some sort of a "flushing" system that would send fin antiseptic solution to every part of the wound" For this two things were obviously necessary —first, a proper solution, and? second, a proper apparatus for applying or distributing it. The aid of th£ Eiiglish chemist, Mr. H. D. Dakin, was elicited in discovering tho solution, and tffter experiments with more, than 200 matures the solution now in use—a onehalf of one per cent, solution of hypooholorite of soda, to which is added a small amount of boric acid—was. decided upon. This is really, only a. very pure oxygenated solution' of common salt. A great point in its favour is its negligible cost of 3 centimes Dor litre.

In experimenting: with the appara-Dr.-Carrel first raado tests of allowing the liquid to fall upon tho surface of the wound from above, and then drawing it into the wound and carrying it away through, the action of a suction pump working on a number of perforated rubber tubes buried in the flesh. Ultimately this plan, gave way to practically its of carrying the solution to the wound in ■perforated tubes buried in the flesh, and allowing iLto .drain away by gravity. By the system as finally perfected, and as at present in use. the solution is carriet[_ a receptacle at the head or the foot of the bed, and once every two hours, by opening a pfndicock on the main rubber tube leading down to the wound, the latter is thoroughly flushed' with tho liquid under a 4 or 5 foot pressure. Striding Results. No sooner was the- system put into regular operation than striking evidences of its efficacy were apparent. The daily microscopic examinations showed that the bacteria of i infection in wounds unde.r treatment were de-' creasing, .at a. rate known before, with the result that the actual healing of tho wounds was accomplished in far less time,, eftea from a "half to a third, than they had required under the ordinary treatments. When. the microscopic study showed the disappearance of all traces of infection, .it was found practicable to close the wound, either by stitching or with adhesive plaster, at once. The wound was as good as healed, and with the incalculable advantage over the old way of cicatrisation that the area of stiff, useless scar tissuo 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 tho "method Carrel" has been the mathematical working out of a "law of cicatrisation." Dr. Carrel noted, that the rate of healing of a number j of wounds as plotted on the chart showed a remarkable regularity. The assistance of the French physicist and mathematician Dr. Noriy was sought in establishing a formula, and, incredible as it_ may seem, the progress of patients in the Compiegne Hospital can now be almost exactly calculated on a graph, and the day of their cureaccurately predicted. Dr. Nouy obtained the "Index of Cicatrisation" bj , working it out from the age of the man and tho difference between the area of the wound on the first day of treatment and on the fourth. By plotting out "lines of healing" for men of 40, 32, 30, 25, and 20 years, it was possible to obtain' the index by simply drawing a horizontal line from the point indicating the size of the wound in square centimetres, to out the curve of the age of the patient, and dropping a perpendicular from there to the base line. When the index was obtained, all that was neceSßary was to put it into the formula, and work out the result, which was the .number' of days it should take the wound to heal under treatment by the "method Carrel." The actual ourve of healing of all normal wounds has worked out practically identical with the theoretical curve in ninety-nine cases out of a hundred. The great practical value of healing in advance isthe standard it sets for the- rate at which tho wound ought to close. Any sharp deviation from the curvo indicates at once that something is wrong.'_ too, it : enables the hospital authorities to figure weeks in' advance the rate at Which patients can bo discharged, and at which beds will be vacant to receive new ones.