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November 24, 1945

TREATMENT OF SEVERE NECROTIC LESIONS: HIGHER PENICILLIN DOSAGE WITH SIMULTANEOUS REGIONAL SYMPATHETIC BLOCK

JAMA. 1945;129(13):869-870. doi:10.1001/jama.1945.92860470002007a
Abstract

Gas gangrene has been reported in fairly large numbers in this war. Forty-four cases with 13 deaths and 8 additional amputations in recovered patients were reported by MacLennon1 in British army casualties in the North African campaign, an incidence of between 6 and 7 per thousand wounded. Twenty cases were seen by Power2 in 6,000 casualties in the fighting in Normandy. In 16 of these patients there were 10 amputations and 2 deaths.

Despite increase in the potency of antiserums and chemotherapy, local and systemic, results of treatment of gas gangrene are not much better than they were twenty-five years ago.1 A consideration of the problem makes it obvious that the reason for failure is twofold : There is an inadequacy in blood supply to necrotic tissue and therefore the amount of penicillin reaching this tissue at the usual blood level is completely inadequate. This may

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