HEALING WOUNDS BY IRRIGATION.

Pukekohe & Waiuku Times, Volume 6, Issue 272, 4 May 1917, Page 2 (Supplement)

HEALING WOUNDS BY IRRIGATION.

MARVELLOUS SURGERY IN*

FRANCE

Thero is a great hospital in Franco solely given over to the treatment of wounded soldiers. There are many such hospitals in France, m England, and crowded over the face of Europe, but this one hospital 'n France is unique, for in it no man has yet died from the effect of his wounds. The hospital is built at Compeigne, and was established after the outbreak of war by the Rockefeller Research Institute tor the purpose of testing a new method of healing wounds, devised by the famous French 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 tho dog was able to scratch himself with the claws of the transplanted leg. The American Sunday papers hailed him liecause of some astonishing experiments conducted in tho rejuvenation of old dogs and cats. Scientists recognised, of course, that Dr. Carrel's "modern miracles" wcro only picturcsquo incidents in an important investigation into human tissues, and that tho surgeon stood on the eve of a discovery that would lie vastly more important to humanity than the accomplishment of gruesome wicks with cats and dogs. Tiie war directed Dr. Carrel's investigation into one particular channel, which led to the discovery in tho treatment of wounds of what is now known as the "Methods of Irrigation Intermittent Carrel," and has given the hospital at Compeigne it 3 wonderful record of rapid and effective cures.

It took onl ya few months' experienco of war to show the French surgeons that the greatest service that science could render to the medical profession would bo a cheap and 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 a couple of years ago. Carrel therefore adopted letter sterilisation, perfect sterilisation if humanly possible, as his lino of endeavour. The Rockefeller Insttiuto put its unlimited resources at his disposal, and this enabled the surgeon to elicit the aid o't" the best special talent that the world, outside of tho Central Powers, afforded.

It has generally !>een 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 tho antiseptic. Dr. Carrel at tho outset conceived the idea that, just as ono washes a e]>onge by repeated saturations and wringings, so should a wound lie washed by some sort of a "flushing" system that would send an 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 the English chemist, Mr. H. D. Dakin, was elicited in discovering the solution, and after experiments with more than 200 mixtures the solution now in use—a one-half per oent. solution of hypochlorite of soda, t-o which is added a small amount of boric acid —was decided upon. Thi-, is raal'.y only a very pun* oxygenated s;lti'.:on JI common salt. A great point in itj itrour is its negligible cosf of- iJ ceatiujjs per litre. In experimenting with the app.ir.i'us Dr. Carrel first made tests of allowing the liquid to fall upon the surface of the wound from above, and then drawing it into the wound and then drawng it into the wound and carrying it away through the action of a suction pump working on a number of perforated rubber tubes bured in the flesh. Ultimately this plan gave way 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 the system as finally perfected, and as at present in use, the solution is carried in a receptacle at the head or the foot of the bed, and once every two hours, by opening a pinch-cock on the main rubber tu!>o leading down to tho wound, tho latter is thoroughly flushed with the liquid under a 4 or 5 foot pressure. No sooner was the system put into regular operation than striking evidences of its efficacy were apparent. The daily microscopic examinatons showed that the bacteria of infection in wounds under treatment were decreasing at a rate never known before, with the result tihat tiu? actual liealing of tho wounds was accomplished in far less time, often 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 piaster, at once. The wound was as good as healed, and with the incalculable advantage over the old way of cicatrisation that tue area of stiff, useless scar tissue was reduced almost to nothing. Nnety 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" lias been tho mathematical working out of a "law of cicatrisation." Dr. Carrel noted that the rate of healing of a number of wounds as plotted 011 the chart showed a remarkable regularity. Tho a.ys ; stance of the I'Vench physicist and mathematician Dr. Nouy was sought in establishing a formula, and, incredible a« it may seem, the progress of patients in the Compeigne Hospit.il can now be almost exactly calculated on a grapn. and the day of their cure accurately predicted. Dr. Xouv obtained the " Index of Cicatrisation" by working it out from flic age of the man and the deference between tho area of the wound on tho first day of treatment and on tlie fourth. By plotting out " lilies of healing "for men of 40, ,'V2. .')0, 21 and -'() vent's, it was ivossible to obtain the index by simply drawing a horizontal line from tne point indicating the size of the wound m .square centili'Otres. to cut the curve of the ago of the patient, and dropping a perpendicular trom there to tlio base line. When the index was obtained, all that was nocovsary was to put it into the formula, and work out. the result, which was the number of davs itvhouhl take the wound to in al under treatment by the " method Carrel". The actual curve el hej'ing of all normal wounds lew worked out practically identical with the theoretical curve in ninety-nine cases out ot a hundred. The great practical value ot licng able to calculate the curve oi heiling ill advance is the standard it >et - for the rate ;it which the wound ought t.i close. Anv sharp deviation from i!x> curve indicates at oiim that si nieth'iiii i> wrong. Incidentally, too. ii enables the hospital authoi'itie- to figure wcok> in advance the rate at winch patients can be <1 is- < barged, and which beds will be vacant to receive new ones.