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THE CLOSED PLASTER METHOD OF TREATING COMPOUND FRACTURES AND INFECTED WOUNDS

JAMA. 1940;115(12):1022-1023. doi:10.1001/jama.1940.02810380052014.
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The treatment of compound fractures and infected wounds during the war of 1914-1918 underwent numerous changes. The general trend was toward the local use of chemicals to kill the bacteria and check the sepsis. Carrel and Dakin, the last and most successful exponents of this trend, introduced on a large scale continued irrigation of the wound with sodium hypochlorite, the antiseptic property of which was combined with weak toxicity for tissues. The postwar contributions of Baer of Baltimore and of H. Winnett Orr of Lincoln, Neb., introduced a new principle in the treatment of these conditions, that of physiologic rest to the injured part. The principle is embodied in Orr's closed plaster method, the essential feature of which is the complete immobilization of the soft tissues. No attempt is made to kill the organisms by external agents. The reliance is placed entirely on the ability of the body to resist bacterial infection.

The first large scale experiment in the appliance of these principles was made possible in the Spanish war. There chiefly owing to the enthusiasm of Trueta, chief surgeon of the General Hospital of Catalonia, the method was adopted in the medical service of the

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