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A Study of Fifty Cases Treated by Flavine

1917; BMJ; Volume: 2; Issue: 2974 Linguagem: Inglês

10.1136/bmj.2.2974.849

0959-8138

E. F. Bashford, J. N. J. Hartley, J. T. Morrison,

Dye analysis and toxicity

SINCE the beginning of June one of our wards has been devoted to an.investigation of tlhe clinical results of the application of flavine to war wounds.At the same time an attenmpt lhas been made to interpret these restults with the help of histological and bacteriological methods.The flavine used lhas been for the most part " 1 acriflavine " s-ent out by the Medical Research Committee, but latterly samples of proflavine from the same soutrce were substi- ,tuted.The results were suLbstantially the same wvith both.TE:CHNIQUE.Thle primlary object of tlle worlk being to confirm tlle good results claimned by the earliest workers with flavine, we made a point of adleriing as closely as possible to tlhe lines of treatment laid down by them-.Tihe skin was careftully cleaned -ith neutral sodium oleate solution and covered witlh sterile strips of bandage cloth permeated *ithT steiiized vaseline, the wountid was swabbed out witlh gauze wrung liglhtly ou't with flavine, all obvious necrofic tissue Cut cleanly away, and every recess tlhen packed withi strips of da-essing soakeed with flavine solution (1: 1,000).As far as possible lint was used for the dressing, on the ground that it retains within -its meslh a inielh larger quantity of the fluiid it is desired to apply to tlle wound surface tlhan gauze, but it was fouLnnd that in small or irregular cavities pieces of gauze are often more convdnient.In a few cases, whe-le long tracks or ,pockets difficult of access had to be dealt with, Carrel's tuibes were used for the purpose of a four-hourly instilla- tion of the flavine s'olution, 10 c.cm. per tube.The flavinie solution was used throughlout at tlle original strength of 1: 1,000, although we notice that certain work-ers in France 2 'suggest that after a few days it is advisable to dilute it down to 1: 5,000.Tlle last step in the dressing was to apply an impe^i-meable covering.For this pturpose one or two thicknesses of the bandage cloth soaked in vaseline.already referred to, were used.Needless to Say, carefui splinting and renmoval of foreign bodies was carricd out 'where necessary.TYPES or CASES DFALT WVITI.On accoult of the experimental nattre of tlhe treatmuent, thle cases were carefullv arranged in a series of gradually increasing severity.Tihe wounds, taken as a whiole, were not of great gravity, and this fact should be remembered in estimating thie value of the treatment.Almost all lhad been treated previously at t'he front by the Carrel-Dakin mlethlod witliin twenty-four hours; of being wouinded, and, in tlle nmajority of instances, very efficiently.No wounds involving tlle cavities of the Lead, chest, or abdomen were included.METHoI) OF INVESTICATIONN.