[Useful dressing in plastic surgery].
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A total number of 64 anesthetized Finnish home bred pigs were wounded in the soft tissue of one thigh. The shooting range was 30 m and 100 m. The weapons were the Finnish M 62, the Russian AKM 47 and the American M 16 A 1. The projectiles were their standard ammunition. Simulating typical field conditions the skin of the pigs was covered by a Finnish field uniform. The skin and the uniform were not cleaned. After trauma the anesthetized pigs were treated in a field hospital and thoroughly examined both clinically and by laboratory tests. Immediately after wounding the wounds were dressed with sterile bandages, which were not touched for 6 hours. Bensyl-penicillin, 300000 units, was administered intravenously to every second pig 1-2 hours after trauma. The wounds were debrided 6 h after wounding and biopsies of devitalized tissue were taken for quantitative bacteriological culture and histological examination. In a group of 12 pigs the specimen was taken 72 h after trauma. After penicillin administration bacterial counts were negative in all wounds but one. No significant contamination was caused by the 7.62 calibre projectiles, but after 6 hours a bacterial count of 102-104/gram of tissue was found in 20% of wounds due to 5.56 calibre shots. The infection was verified histologically. All the wounds in the 723-hour group showed heavy secondary contamination. The study shows that early antimicrobial therapy was useful especially in the case of severe and complicated soft tissue missile wounds in the pigs.
This paper reviews different types of treatment of the amputation stump. Following an examination of the historical development there are sections on bandaging, semi-rigid dressings, rigid cast dressing and controlled environment treatment. The merits and demerits of each type of treatment are discussed.
Single-layer foil bandages which belong to the group of so-called occlusive bandaging materials were originally developed from incision foils. Due to their semipermeability theses bandages permit only restricted evaporation of water from the wound and thus maintain its surface constantly slightly wet. They can be used for longer periods and are thus more economical. Although foil bandages are suitable only for some types of wounds, they have great advantages. Wounds dressed with these foil bandages can be easily and frequently checked and offer wounds excellent antimicrobial protection.
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