The History of Wound Healing.

Since the dawn of humanity, wounds have afflicted humans, and healers have held responsibility for treating them. This article tracks the evolution of wound care from antiquity to the present, highlighting the roles of surgeons, scientists, culture, and society in the ever-changing management of traumatic and iatrogenic injuries.

Historical review of Dakin's solution applications.

Dakin's solution and the Carrel-Dakin method were developed and integrated into clinical practice in the early 20th century, which were found to aid in effective wound healing and infection. This historical review briefly outlines highlights with regard to the history of infection management, wartime amputation, and wound treatment dating back to Galen through the early 20th century. This paper extensively reviews and discusses the historic use of Dakin's solution, which was developed almost a century ago, in both wartime settings and in the civilian sector as well. This review further elaborates on the use of Dakin's solution in the current treatment of wounds in the United States. Additionally, we discuss the history of wound care with the emphasis on the Carrel-Dakin method. Finally, this review discusses and presents contemporary application and utilization of Dakin's solution in two large tertiary care centers.

[The treatment of wounds during World War I].

The First World War was a huge tragedy for mankind, but, paradoxically, it represented a source of significant progress in a broad series of human activities, including medicine, since it forced physicians to improve their knowledge in the treatment of a large number of wounded soldiers. The use of heavy artillery and machine guns, as well as chemical warfare, caused very serious and life-threatening lesions and wounds. The most frequent causes of death were not mainly related to gunshot wounds, but rather to fractures, tetanus and septic complications of infectious diseases. In the first part of this article, we describe the surgical procedures and medical therapies carried out by Italian physicians during the First World War, with the aim of treating wounded soldiers in this pre-antibiotic era. Antibacterial solutions, such as those of Dakin-Carrel and sodium hypochlorite and boric acid, the tincture of iodine as well as the surgical and dressing approaches and techniques used to remove pus from wounds, such as ignipuncture and thermocautery or lamellar drainage are reported in detail. In the second part of the paper, the organization of the Italian military hospitals network, the systems and tools useful to transport wounded soldiers both in the front lines and in the rear is amply discussed. In addition, the number of soldiers enrolling, and those dying, wounded or missing during the Great War on the Italian front is estimated.

[Great discoveries: from the painstaking efforts of researchers to the contribution of accidental findings and the dissemination of study results]. / Le grandi scoperte: tra caparbietà, casualità e diffusione dei risultati della ricerca.

This article takes its cue from the original work of sir Alexander Fleming on penicillin, published in the first issue of Recenti Progressi in Medicina in 1946 and reproduced here on the occasion of the approaching 70-year anniversary of the journal. The path that brought Fleming to the discovery of penicillin, one of the major milestones in the history of clinical pharmacology, provides insight for a range of considerations: the painstaking efforts of researchers, the contribution from accidental findings, and the dissemination of study results. Although the discovery of penicillin has changed the course of medicine, the benefits deriving from such an important advance are most likely to be offset by the overprescription of antibiotics, which is the leading cause of antimicrobial resistance and one of the most serious public health problems of our time.

Surgical Skills Beyond Scientific Management.

During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

Clínica de heridas y estomas, una propuesta de enfermería especializada / Clinic of wounds, and stomata, a proposal for specialized nursing

Las lesiones de la integridad de la piel, las úlceras por presión (UPP) en pacientes hospitalizados representa un problema importante debido a su prevalencia, a la vez que afecta la calidad de vida del paciente, e implican consecuencias socioeconómicas para la persona, familia e instituciones de salud, ya que aumenta la morbimortalidad, su prevención y manejo competen en gran parte al profesional de enfermería

The lesions of skin integrity, pressure ulcers (UPP) in hospitalized patients is a major problem because of its prevalence, while affecting the quality of life of patients, and involve socioeconomic consequences for the individual, family and health institutions, increasing morbidity and mortality, prevention and management competence largely to nurse

El cuerpo herido conocimiento y simbología del arte / The wounded body, unkowledge and art symbolism

Breve recorrido a través de todos los períodos artísticos, analizando y buscando, para poder determinar el significado y simbología de la herida en cada época. Estudiar la relación y simbolismo arte/cuerpo/herida, es una vasta y compleja tarea. Se puede abordar desde todas las perspectivas imaginables. Distintas disciplinas como la antropología, la historia y la filosofía, la medicina, y ahora el arte, nos han proporcionado diferentes lecturas acerca de la representación y el significado del cuerpo humano herido a través de los siglos(AU)

A brief tour thought all art periods, analyzing and searching, to determine the meaning and symbolism of the wound in each period. To study the relationship and symbolism art I body I wound, is a vast and complex task. Can be approached from every angle imaginable. Defferent disciplines such as anthropology, history and philosophy, medicine, and now the art, we have provided different interpretations about the meaning representation and wounded human body through the centuries(AU)

Infection in conflict wounded.

Although mechanisms of modern military wounding may be distinct from those of ancient conflicts, the infectious sequelae of ballistic trauma and the evolving microbial flora of war wounds remain a considerable burden on both the injured combatant and their deployed medical systems. Battlefield surgeons of ancient times favoured suppuration in war wounding and as such Galenic encouragement of pus formation would hinder progress in wound care for centuries. Napoleonic surgeons eventually abandoned this mantra, embracing radical surgical intervention, primarily by amputation, to prevent infection. Later, microscopy enabled identification of microorganisms and characterization of wound flora. Concurrent advances in sanitation and evacuation enabled improved outcomes and establishment of modern military medical systems. Advances in medical doctrine and technology afford those injured in current conflicts with increasing survivability through rapid evacuation, sophisticated resuscitation and timely surgical intervention. Infectious complications in those that do survive, however, are a major concern. Addressing antibiotic use, nosocomial transmission and infectious sequelae are a current clinical management and research priority and will remain so in an era characterized by a massive burden of combat extremity injury. This paper provides a review of infection in combat wounding from a historical setting through to the modern evidence base.

Polihexanide for wound treatment--how it began.

The essential role of wound antiseptics was discovered in the 18th century. Since then, many different procedures and substances have been developed and used for this indication. In the 1980s, polihexanide was introduced by Prof. Willenegger in Switzerland. Today, consensus recommendations confirm the potential of this substance for wound treatment. Various polihexanide-containing wound care products are available and these are now also gaining in importance throughout Europe and throughout the world.

[Sulfonamide-research on human subjects in Nazi concentration camps: a critical re-evaluation of the epistemological and ethical dimension]. / Die Sulfonamid-Experimente in nationalsozialistischen Konzentrationslagern: Eine kritische Neubewertung der epistemologischen und ethischen Dimension.

Existing scholarship on the experiments performed in concentration camps beginning in 1942 on the value of sulfonamides in treatment of wound infections, in which inmates were used as experimental subjects, maintains that not only were the experiments ethically and legally completely reprehensible and unacceptable, but that they were also bad science in the sense that they were investigating questions that had already been resolved by valid medical research. In contrast to this, the paper argues on the basis of contemporary publications that the value of sulfonamides in the treatment of wound infections, including gas gangrene infections, was not yet established, that is, that the questions pursued by the experiments had not been resolved. It also argues that regarding their "design" and methodical principles, the experiments directly followed the rationality of contemporary clinical trials and animal experiments. However, for the step from animal to the human experiment, the experimental "objects" were only in regard to their body, but not to their individuality and subjectivity regarded as "human". In a concluding section, the paper lines out some implications for an adequate historical reconstruction of medical research on humans, in particular the importance of a combined focus on the scientific rationality as well as explicit or implicit value hierarchies. Further, the article points to the potential impact of such a revised image of the sulfonamide experiments for present day debates on the ethics of medical research.

Anecdotario histórico de las heridas crónicas. Personajes ilustres que las han padecido / Compilation of historical anecdotes about chronic wounds well-known people who has suffered them

A lo largo de la historia de la humanidad muchas personas se han visto afectadas por la presencia de heridas crónicas. Millones de personas anónimas han padecido úlceras por presión, venosas, arteriales o neuropáticas. Pero también han existido personajes famosos que, de vez en cuando, sacan estas lesiones de su invisibilidad. En nuestros días, cada vez que alguna persona famosa las padece, vemos cómo los medios de comunicación se hacen eco del problema. Pero, en el pasado, también personajes ilustres las sufrieron. En el presente artículo histórico efectuaremos un repaso a personajes históricos que también han muerto por las temidas «llagas». Así, reyes o santos, se han visto afectados por este problema. Concretamente nos centraremos en seis personajes históricos: tres reyes, un compositor y dos santos y analizaremos la influencia de las heridas crónicas en la causa de su muerte. Artículo expuesto en el VII Simposio Nacional de Úlceras por Presión y Heridas Crónicas y I Congreso Latinoamericano sobre Úlceras y Heridas(AU)

Throughout the course of human history, many people have been affected by the presence of chronic wounds. Millions of anonymous people have suffered bed sores, varicose ulcers, arterial ulcers or neuropathic ulcers. But there have been some famous people who, from time to time, remove these lesions from their cloak of invisibility. In our day and age, every time a famous person suffers from these wounds, we observe how the means of communication publicize this health problem. However, famous people also suffered from these wounds in the past. In this article, the authors will review historical figures who died due to these feared sores. Kings or saints have been affected by this problem. Specifically, the authors will focus on six historical figures: three kings, one composer and two saints; the authors shall analyze the influence of chronic wounds as a cause of their deaths. This article was submitted at the VII National Symposium on Bed Sores and Chronic Wounds and at the First Latin American Congress on Ulcers and Wounds(AU)