Abdominal surgery: at a field surgical unit

Abstract

The evolution of field surgical units in relation to mobile warfare is discussed.The experience of a field surgical unit is described in respect of the 1944 -45 campaign of the British Liberation Amy (B.L.A.), with special reference to administration.Sixty seven cases of abdominal wounds are analysed and the results compared with those of other surgeons in a brief historical review. There were twenty one deaths and a mortality rate of 31.3 per cent.The clinical aspects of diagnosis and treatment are discussed with special reference to the treatment of injuries to the colon, and to the effects of sulphonamide drugs and penicillin on the post operative phases. A preference is expressed, supported by clinical evidence, for the policy of suture and valvular caecostomy rather than exteriorisation of wounds of the colon in selected cases. To obtain their maximum benefit, chemotherapeutic agents should be administered parentally from as near wounding time as possible rather than to await the time of operation.The employment of special centres for the treatment of abdominal cases only is discussed with favour, together with other possible improvements in the treatment.