The Washington times., 1917-04-06
CARREL TREATMENT
SAYING MANYLIVES
DR.. H. H. M. Lyle, Professor OF
Surgery at P. and s.. Tells
of Observations Abroad.

NEW 1ORk, April o.--NeHe"eu u"
teFest in the Carrel-Dakin treatment
of:fnfected wounds, the success OF
which in the field hospitals of France
has won world fame for its inven-
tors has been stimulated in this
country by recent announcement that
DR.. Alexis Carrel is to return here
to take charge of a military unit
hospital to be erected by the Rocke-
feller- Institute for Medical Research,
in which the Carrel-Dakin method is
to be practiced and taught to army
surgeons, public health experts, ana
Red Cross nurses
DR.. H. H. M.1yle, professor Of clin-
fcal surgery at the College of Physfc-
ians and Surgeons of Columbia Uni
versity and attending surgeon at ST.
Luke's Hospital, while Chirugiein en-
Chef at the Ambulance d'Annel, Oise,
France, had large experience with the
new wound treatment and wrote
Elowfngly of its results. In a paper
contributed to the surgical section OF
the New York Academy OF Medicine
and printed in the Journal of the
American Medical Association, DR..
Lyle explained in detail the technique
of the method, and continued:
"In the early months OF 1915 / was
in charge OF Hospital B, American
Ambulance. This hospital contained
$50 beds, and was situated at Juilly,
Seine ct Merne, forty miles behind
the firing line. The wounded were
brought from Compiegne in automo-
bile ambulances, arriving in Juilly
about twenty-fourN hours after being
wounded. This year my experience
IVES gained while surgeon in CHIEF
Of an ambulance situated three and
onelhalf miles behind the firing line.
- Method of Procedure.
at Hospital the following pro-
eedure was Immediately carried out.
"1.. Careful examination of the sol
dier's clothes to determine the abb
sences or presence Of clothing in the
wounds.
'2. Examination and dressing Of
the wound.
"a LocaliZation by Roentgen ray OF
all bullets, shell fragments, etc. and
their Immediate extraction. The after
treatment was according to accepted
Eurgical principles. We were satisfied
with the results obtained, as they COM
pared favorably with those of similar
hospitals. Today we should consider
them failures. We had the usual num-
ber of pussing wounds, pyocyaneous in
fections, secondary assesses, osteomye-
litis, Joint complications. amputations
fer infection, delayed heallngs, etc,
along with the worries and uncertain
ties which are incident to such cases.
For the first ten days at the front
we followed the old standard methods
end the newer physiologic ones. Mean
while We were tentatively trying out the
Carrel method. At the end Of this time
the contrast in the results was SO strik-
r1aathnd
for the hospital.
Our experience was that Of Depage:
The transformation which was estab-
lished in our results was startling The
immediate complications became more
and more rare, and suppuration disap-'
peared. from our services almost COM
pIetely' In our service during four and
a half months no secondary atscess de-
deloped. there was only one case Of
osteomyelitic, and this responded read
fly TO treatment There were no ampu-
tations for infection. The average stay
for wounds of soft parts was fourteen
days, for compound fractures from
twenty-eight to tbirty-six days
The wounds treated were almost
exclusively inflicted by high explosive
shells, shrapRel, trench tcrpedoes,
bombs. hand grenades, etc. Very few
bullet wounds were received.
Closed $50 Wounds.
"Depage reported his results OBJ
tained at the Ambulance de la Panne
from June / TO. August as 1871 cases
sutured, complete union in 112, par
tial union in %, failure in 2 cases.
These figures include 6 wounds of the
knee. IL amputation stumps, II frac-
lures, and 102 wounds OF the soft
parts. On the date of August De-
page had so compound fractures with
out a drep. Of -pus. In August the
Ambulance .Carrel had closed 450
wounds with only 6 failures.
The Carref method is not a con-
tinuous irrigation. 1t is not depen-
dent on the miraculous power of an
antiseptic, or on any one feature Of
the method, but on the combination
Of the whole 1t is a method OF ster-
ilizing wounds by mechanically de-
livering an antiseptic of definite
chemical concentration to every por-
tion Of a. surgically prepared wound
and insuring its constant contact for
a prolonged period. The progress OF
the sterilization is vigorously con-
trolled by. the microscope. Gentle
ness, thoroughness, and attention to
detail are essential for success. /
firmly Believe that the adoption OF
this method is destined to save many
lives. 10 reduce the gravity OF thk
mutilations, and allow the. rapid re-
turn to the front of many men who
would otherwise be lost to the SER