Other formats

    TEI XML file   ePub eBook file  

Connect

    mail icontwitter iconBlogspot iconrss icon

War Surgery and Medicine

FIRST WORLD WAR

FIRST WORLD WAR

IN the First World War severe burns were not as common as in the Second World War, though there were at times the special burns associated with mustard gas. This is accounted for by the limited use of petrol in the First World War.

The treatment of burns consisted in the application of various antiseptic dressings. Picric acid in a 1 per cent aqueous solution was commonly used. Ambrine sprayed on to the burnt area was also utilised extensively and was very useful for the more superficial burns, providing a protective and soothing dressing and preventing cross infection. The application of vaseline and tulle gras dressings was a development of the same principle. With ambrine for the more superficial and picric acid for the deeper burns, good results were undoubtedly obtained, but in the absence of adequate resuscitatory measures, and the non-recognition of the profound blood changes present, there was a high mortality from shock.

As a primary application, carron oil had been used before the war, but had been discarded. Later in the war eusol and then Dakin's solution was used as a dressing, both to prevent and to clear up infection. Skin grafting was utilised in the treatment of the severe burns, after preparation with Dakin's solution. The treatment by picric acid carried with it some danger of absorption when used over large raw surfaces, but it was generally a very satisfactory form of treatment.

A radical alteration in the treatment took place after 1925 when tannic acid was introduced by Davidson, and reports were published in America claiming a marked decrease in mortality following its use in several of the larger hospitals. At the same time there was a better appreciation of the treatment of the severe shock associated with extensive burns, and it is possible that part at least of the decrease in mortality was due to the better treatment of shock and the generally better treatment of the patient. The tannic acid treatment then became almost universal, and at the beginning of the Second World War it was the treatment of choice.