Other formats

    TEI XML file   ePub eBook file  

Connect

    mail icontwitter iconBlogspot iconrss icon

New Zealand Medical Services in Middle East and Italy

Work at 3 General Hospital

Work at 3 General Hospital

No. 3 General Hospital at Bari was the last link in the chain of evacuation in Italy. Patients were evacuated from 2 General Hospital at Caserta by train, a few being transferred by ambulance, and some special cases by air. At first, the train took the patients only part of the way, the rest of the journey being by ambulance, and this generally involved thirty hours' travelling. Later, in March, the train took the patients all the way to Bari in fourteen hours.

Certain types of cases, notably fractures of the femur, were sent on to Bari at the earliest opportunity so that all secondary treatment could be undertaken there.

The outstanding feature of wound treatment at this period was the experimental investigations carried out with penicillin. Major Scott-Thomson, pathologist to the penicillin control unit, set up a laboratory in the hospital in January, and certain groups of cases were selected:

(a)

For treatment with sodium penicillin parenterally:

(i)

compound fractures of the femur and tarsus,

(ii)

cases of infected haemothorax.

(b)

For treatment with calcium penicillin locally to the wound:

(i)

soft-tissue wounds for delayed primary and secondary suture,

(ii)

burns.

The methods used were:

(a)

Compound Fractures of Femur and Tarsus. The method originally adopted by Lieutenant-Colonel Jeffreys, RAMC, was to explore, cleanse, and suture loosely the wounds of the thigh on admission, and give 15,000 units intramuscularly three-hourly for five to six days. This method was altered later and penicillin was injected for five to six days before suture. Dressings were left unchanged for two to three weeks.

(b)

Infected Haemothoraces. Two methods were used:

(i)

Intramuscular injection was given for five days and the chest aspirated.

(ii)

Sodium penicillin solution was injected into the pleural cavity and the chest aspirated. After rib resection and drainage, penicillin was instilled daily into the chest, suction being interrupted for some hours.

(c)

Secondary Suture. Two methods were used:

(i)

Application of calcium penicillin locally for five or more days until a swab from the wound showed no growth of staphylococci or streptococci. Wound was then excised, page 550 powder applied, and suture performed. Small rubber tubes were inserted through stab wounds, and calcium penicillin fluid instilled twice daily.

(ii)

Same as under (i) but suture without tubes.