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CHAPTER 13
1946; Matson, 1948). Matson admitted that decompression is the least urgent of reasons
for early laminectomy and Haynes clearly stated that the prognostic difference between
laminectomy at 48 hours and 10 days is of minimal difference although he himself was in
favour of removal of bone debris and foreign bodies under 48 hours. Matson, although
advocating that compression should always be relieved as soon as possible, agreed that
incomplete lesions of the cord in whom the neurological deficit has increased were
extremely rare during the Second World War 'which lends weight to the belief that the
greater part of the physiological loss is due to damage produced at the moment of injury
rather than by subsequent compression'. There is, however, general agreement that
peripheral vascular collapse demands priority over any other treatment, and there is no
doubt that the treatment of traumatic shock by immediate plasma and, even better, full
blood transfusions has saved many lives, especially in spinal injuries associated with
chest and abdominal injuries.
TREATMENT OF WOUND INFECTION
In spite of all preventive measures, as outlined above, wound infection has occurred
following gunshot injuries during the Second World War although infinitely less as
compared with the First World War, thanks to the introduction of sulfonamides and,
especially, since the discovery of penicillin. Our very first traumatic paraplegic following
gunshot injury, admitted after the opening of the Stoke Mandeville Centre on 2 February
1944, developed an epidural abscess which, however, healed after opening and penicillin
FIG. 88a.
