CURE OF WOUNDS

Wairarapa Times-Age, 2 May 1938, Page 10

CURE OF WOUNDS

WHAT MUST BE DONE Thousands of accidental wounds occur daily, a great many because dirty objects have penetrated bacteria-laden skin (writes Dr Irving Cutter in the Chicago .“Tribune”). They are quite different from the cuts made by the skilled surgeon, who —under ideal conditions of cleanliness —may open the abdomen with safety. Nature has a clever way of aiding us in our ignorance and mistakes. Whenever the body covering is broken there is an outpouring of fluid from the vessels and a gathering of white blood cells which engulf and digest bacteria and broken fibres. Then comes the formation of a new type of repair material, called connective tissue, which fills in the space that has been created. If there is no infection, mending rarely will occupy more than 10 days, and unless the laceration is extensive the part will be as strong—or nearly so —as it was originally. As we know, bones heal more slowly, but solidly. The great enemy of prompt recovery is contamination, and the chief sources are bacteria, bits of clothing, and pieces of metal, wood and glass. Any foreign substance will interfere, even though it is not infected. The first’ rule, then, is to remove all dirt and macerated fragments (those which have been cut off from adequate blood supply). Furthermore, blood clots should be cleaned away, as they form favourable,nests for the growth of microbes. We can, however, with reasonable security leave a considerable amount of debris for the white cells to work upon and devour.

In such an emergency stopping haemorrhage is essential. Pressure is usually sufficient to control blood loss, and a firm bandage—a necktie will do —tied around the limb above a bleeding point will halt the flow. Such a bandage should not be allowed to remain on too long. Sometimes a stricture cannot be applied, as when the wound is in the abdominal wall, high in the thigh, on the chest, or about the neck. Compression from without, therefore, must be used and the regjon covered with a clean dressing. We also must endeavour to protect the wound from additional damage, particularly bacterial invasion. Tincture of iodine usually is available in first aid kits, and in the absence of one trained in the care of injuries this may be used to good advantage. The wiser plan, however, after bleeding has been arrested, is to wash the site thoroughly with soap and hot water. Make no attempt to pick away foreign pieces or dirt that cannot be loosened earily in the process. After cleansing, cover the entire area with sterile gauze. It is necessary to get the patient as speedily as may be to a hospital where shock, if it exists, may be treated. If a nerve or tendon has been cut, this, too, demands experienced handling if good function is to be restored.

Scarcely a day passes but we learn of someone who has lost his life from blood poisoning. This is where the streptococcus plays its deadly role. Heat to the affected structures, to increase the flow of blood and supply more microbe fighters (white cells), will help. Still more important is the work carried out by the surgeon. If he will keep the area clean and open, permit the access of air, and provide for free drainage, no prickets will remain for the accommodation of germs. But no pin prick or insignificant cut should be allowed to go unattended. Nature sometimes fails to appreciate the joke of neglect.