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Erysipelas and Death Following a Lacerated Wound
E rystpelas ant/Death follo w£ng a Lacerated Wound.
20 I
ERYSIPELAS AND DEATH FOLLOWING A LACERATED WO U ND. BY C APTA IN
C. B. M.
HARRIS,
D.S.O., CANT ER llU RY •
.oN the morning of 20th January last, I admitted into hospital a bay mare, 7th Dragoon Guards, aged 5 years, suffering from a severe I lacerated wound anterior to point of off hip, caused by collision with a cart, whilst at exercise. Examination re vealed considerable hre morrhage, extensive bruising .of tissues around the wound, and, owing to the peculiarity of th e part, a " pocket" between the loose skin anterior to the faschia,lata and the abdominal faschia beneath, from which most of the blood emanated. The wound was washed with hot water, syringed out with Sol. Hydrarg. Perchlor. (1.1 ,000), and plugged with carbolized tow. An attempt was made to sling the patient, but this was not persisted -in, owing to her violence. As a precautionary measure I gave subcut aneously 3v of antitetanic serum. Th e mare was then comfortably fix ed up. The te mperature, pulse, and respirations were nor mal. On the evening of same day there was slight swelling a round the wound, but otherwise no change. The temperature, pulse, and respirations, as in the morning , were normal , a nd patient had a good appetite. N e xt morning (January 21), I noti ced a change for the worse. Symptoms: An redematous brawny swelling of off-hind thigh, extending to the hock and beneath abdomen great pain causing pressure and di!ltension of superficial veins. The temperature was 103°, pulse full, and th ere wa s general malaise. T reatmmt.-I prescribed an ordinary stimulant, and inci sed the swellings from which a quantity of serum exuded. Continual fomenta tions were applied, .and the wound was dressed as previously mentioned. Jattuary 2 I, 5 p,m.-The swellings of morning had increased, and the " brawniness" was more marked . Temp. 103°, pulse running down, and patient in a bad way. At 9 p.m. the pati ent struggled violently, colla psed, and died . Post-mortem Examillation.-On opening the swellings a semi-solid inflammatory exudate was evacuated, with sloughing of tissues noticeable in parts. The other organs showed no special features. COMMENTS .
The cause of death was , I take it, syncope due to septic infec tion , a condition due to defective antiseptic precautions, which were unavoidable. I erred in not extending the laceration on first examination of the ca se, and thus doing away with the" pocket, " which undoubtedly favoured the de velopment of septic organisms. I hesitated owing to the extent of the resulting wound.
20 I
ERYSIPELAS AND DEATH FOLLOWING A LACERATED WO U ND. BY C APTA IN
C. B. M.
HARRIS,
D.S.O., CANT ER llU RY •
.oN the morning of 20th January last, I admitted into hospital a bay mare, 7th Dragoon Guards, aged 5 years, suffering from a severe I lacerated wound anterior to point of off hip, caused by collision with a cart, whilst at exercise. Examination re vealed considerable hre morrhage, extensive bruising .of tissues around the wound, and, owing to the peculiarity of th e part, a " pocket" between the loose skin anterior to the faschia,lata and the abdominal faschia beneath, from which most of the blood emanated. The wound was washed with hot water, syringed out with Sol. Hydrarg. Perchlor. (1.1 ,000), and plugged with carbolized tow. An attempt was made to sling the patient, but this was not persisted -in, owing to her violence. As a precautionary measure I gave subcut aneously 3v of antitetanic serum. Th e mare was then comfortably fix ed up. The te mperature, pulse, and respirations were nor mal. On the evening of same day there was slight swelling a round the wound, but otherwise no change. The temperature, pulse, and respirations, as in the morning , were normal , a nd patient had a good appetite. N e xt morning (January 21), I noti ced a change for the worse. Symptoms: An redematous brawny swelling of off-hind thigh, extending to the hock and beneath abdomen great pain causing pressure and di!ltension of superficial veins. The temperature was 103°, pulse full, and th ere wa s general malaise. T reatmmt.-I prescribed an ordinary stimulant, and inci sed the swellings from which a quantity of serum exuded. Continual fomenta tions were applied, .and the wound was dressed as previously mentioned. Jattuary 2 I, 5 p,m.-The swellings of morning had increased, and the " brawniness" was more marked . Temp. 103°, pulse running down, and patient in a bad way. At 9 p.m. the pati ent struggled violently, colla psed, and died . Post-mortem Examillation.-On opening the swellings a semi-solid inflammatory exudate was evacuated, with sloughing of tissues noticeable in parts. The other organs showed no special features. COMMENTS .
The cause of death was , I take it, syncope due to septic infec tion , a condition due to defective antiseptic precautions, which were unavoidable. I erred in not extending the laceration on first examination of the ca se, and thus doing away with the" pocket, " which undoubtedly favoured the de velopment of septic organisms. I hesitated owing to the extent of the resulting wound.