Advanced First Aid for Survival: When the Sh*t Hits the Fan YOU Are the Doctor by Tom Sweet

Author:Tom Sweet [Sweet, Tom]
Language: eng
Format: epub, mobi, azw3, pdf
Tags: Medical Books, Allied Health Professions, Emergency Medical Services, Sports & Outdoors, Hiking & Camping, Instructional, Professional & Technical, Medical eBooks, Outdoors & Nature
Amazon: B00M9F4NSY
Publisher: Vanguard Survival Press
Published: 2014-07-29T04:00:00+00:00

7 INFECTED WOUND CARE

A Brief History of Infected Wound Care The ancient Egyptians were the first civilization to have trained clinicians to treat physical ailments. Medical papyri, such as the Edwin Smith papyrus (circa 1600 BC) and the Ebers papyrus (circa 1534 BC), provided detailed information of management of disease, including wound management with the application of various potions and grease to assist healing.

The scale of wound infections is most evident in times of war and natural disaster. During the American Civil War, erysipelas (necrotizing infection of soft tissue) and tetanus accounted for over 17,000 deaths, according to an anonymous source in 1883. Because compound fractures at the time almost invariably were associated with infection, amputation was the only option, despite a 25-90% risk of amputation stump infection.

Koch (Professor of Hygiene and Microbiology, Berlin, 1843-1910) first recognized the cause of infective foci as secondary to microbial growth in his 19th century postulates. Semmelweis (Austrian obstetrician, 1818-1865) demonstrated a 5-fold reduction in puerperal sepsis by hand washing between performing postmortem examinations and entering the delivery room. Joseph Lister (Professor of Surgery, London, 1827-1912) and Louis Pasteur (French bacteriologist, 1822-1895) revolutionized the entire concept of wound infection. Lister recognized that antisepsis could prevent infection. In 1867, Lister placed carbolic acid into open fractures to sterilize the wound and to prevent sepsis and hence the need for amputation. In 1871, Lister began to use carbolic spray in the operating room to reduce contamination. However, the concept of wound suppuration persevered even among eminent surgeons, such as John Hunter, 1728-1793.

World War I (WWI) resulted in new types of wounds from high-velocity bullet and shrapnel injuries coupled with contamination by the mud from the trenches. Antoine Depage (Belgian military surgeon, 1862-1925) reintroduced wound debridement and delayed wound closure and relied on microbiological assessment of wound brushings as guidance for the timing of secondary wound closure. Alexander Fleming (microbiologist, London, 1881-1955) performed many of his bacteriological studies during WWI and is credited with the discovery of penicillin.

Penicillin first was used clinically in 1940 by Howard Florey. With the use of antibiotics, a new era in the management of wound infections commenced. Unfortunately, eradication of the infective plague affecting surgical wounds has not ended because of the insurgence of antibioticresistant bacterial strains and the nature of more adventurous surgical intervention in immunocompromised patients and in implant surgery.

Internationally, the frequency of wound infection is difficult to monitor because criteria for diagnosis might not be standardized. A survey sponsored by the World Health Organization demonstrated a prevalence of nosocomial infections accounting for 5-34% Nosocomial Infection National Surveillance Service (NINSS), which covers the period between October 1997 and September 2001, indicates that the incidence of hospital acquired infection related to surgical wounds in the United Kingdom is as high as 10% and costs the National Health Service in the United Kingdom approximately 1 billion pounds (1.8 billion dollars) annually.

varying from 3-21%, with wound infections of the total. The 2002 survey report by the

Collated data on the incidence of wound infections

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