Læknablaðið - 01.04.1943, Blaðsíða 10

H4
LÆKNABLAÐ I Ð
both personnel and equipment, and
this feature beconies increasingly
important.
Although most of you are fant-
iliar with the various methods of
treatment, I think that a short
resume of them is in order here,
to freshen our minds on the sub-
ject. I can not hope to mention al!
of the various forms of treatment,
but will briefly mention the more
commonly used ones, with their
advantages and disadvantages.
The forerunner of the present
methods of tanning, or covering
the burned areas with an eschar.
was the Ambrine treatment which
was introduced during the last war.
This consisted of a modified petro-
latum, which melted at a little
higher than body temperature, and
was sprayed on the affected area.
It did diminish pain and helped
to prevent the loss of serum by
covering the raw areas. However.
it was not antiseptic, ntore frequ-
ent, painful, and time consuming
dressings were necessary, and the
method soon fell out of general
favor.
During the next few years, num-
bers of materials were used in the
treatment of burns. One of these
was butesyn picrate in an ointment
base. This had widespread use in
industrial plants, but is is being
replaced largely now.
Before going further into the
more modern methods of treat-
ment, I should again Iike to classi-
fy burns.
First degree. — Here there is
only simple reddening or erythema,
which is similar to a rnild sunburn.
Second degree Here the injury
involvps deeper Iayers of the skin,
with blistering.,
Third degree. Here there is still
deeper involvment, \vith the entire
thickness of the skin being burned,
and there ntay also be involvement
of deeper subcutaneous tissue.
Fourth degree. Many feel that
this addition of the classificatiou
is an unnecessary modification, but
I do not agree. The usual third
degree is too comprehensive. It is
the hodge-podge, into all burns
which are not first or second de-
gree are thrown, although they
varied greatly in depth of involve-
ment. The fourth degree, to me,
is where the thermal injury extends
still deeper, at'fecting deep tissue.
organs, bones, etc.
In war time, where many of
the burns may be complicated by
compound fracture, etc., the treat-
ment of the complicating condition
may become of prime importance.
It may be necessary to pay more
attention to the complicating con-
dition than ío the burn. Although
it is not the purpose of this paper
to undertake a discussion of these
complications, it is necessary to
keep them in mind, as variations
front our outlined jjlan of attack
may become necessary.
The first great step in the
modern treatment of burns was the
rediscovery, or rather the modern
adaptation of the use of tannic
acid in 1925 by Davidson. I say
rediscovery, because the Chinese
have for centuries been using
strong infusions of tea leaves, with
their tannic acid content, in the
treatment of burns.
Nevertheless, the modern adapt-
ation of this therapv, and I include
the addition of silver nitrate to the
tanning process, was the greatest
forward step in the reduction of
mortality and morbidity so far.
This tanning of the affected area
formed a fine protective eschar
whose value was two fold. It pre-