J.Jpn. Surg. Soc.. 55(2): 147-154, 1954

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Original article

SURGICAL APPLICATION OF URETHANE
PART 2
A METHOD OF THE PRIMARY CLOSURE OF WOUND, WHICH IS SOILED OR DIFFICULT TO HEAL, ESPECIALLY OF TUBERCULOUS FISTULAE, BY USING URETHANE, PENICILLIN AND STREPTOMYCIN

1) Mixed infection plays an very important role in the resistance of tuberculous fislulae to any kinds of therapies. The author, therefore, attempted first to eradicate suppurative organismus and then to close the wounds primarily.
2) This method consists, in other words, of (1) debridement, (2) irrigation of the wounds with such solution as that of urethane, penicillin and streptomycin, and (3) primary closure of the wounds.
3) The cases are as follows: tuberculous fistulae -40 and non-tuberculous fistulae -22, 62 cases in total. Urethane has a so marked bactericidal effect against gram-negative bacilli that it is very useful in the treatment of abdominal fistulae caused by coli bacilli.
4) The clinical, bacteriological and histological examinations of each case reveal that this method of treatment has a very favorable influence upon the wounds healing without causing any damage to the individuals.
5) There are only 3 unsuccessful cases (4.8%) in tuberculqus fistulae. A better result can be expected if we observe strict indications. This method is, the author believes, an epoch-making in the treatment of tuberculous fistulae. (author's abstract)

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