They say that life has always had two constants – death and taxes. You can add injury to that rather gloomy list of inevitables. Luckily, human beings have always been innovators. It is what sets us apart from apes!
Wound care has always been an area in which humans have utilized their inventiveness. Throughout history, our knowledge of chemicals, materials and compounds has been put to use to deal with lacerations, burns, bites and necrosis. As sure as human suffering is a constant, human innovation is always pushing for solutions.
There have been many twists and turns in the history of wound care. It is enmeshed with the history of politics and social care, and the development of material synthesis.
Here is a brief chronology of wound care solutions. We will be touching upon some landmark solutions and giving a brief outline of their origins.
Ancient peoples developed many herbal wound cleansing solutions that are often still in use in some form.
Turmeric, iron, honey, and alcohol were all used in ancient Greece, South America, Africa, and Rome to ensure that wounds did not become infected.
Stitches (or sutures) are amongst the most ancient of wound care solutions. Sutures are, in principle, the most basic way of treating a laceration. Essentially, stitches bring together the two sides of a laceration, allowing them to fuse.
Stitches were first described as far back as 3000BC. Ancient Egyptians recorded the medical use of stitches made of hemp and animal arteries. The dominant material for many hundreds of years for the manufacture of stitches was ‘cat gut’. Cat gut is an organic material derived from animal intestine. Recently, cat gut has been back in vouge for the creation of sutures. This is because as an organic material it can be metabolized by enzymes in the body. This means that they slowly dissolve over time, negating the need for invasive stitch removal.
Although ancient peoples were aware that keeping a wound clean and applying alcohol would increase the chances of a wound healing, it was not until the 19th Century that huge advances were made in the field of sterilization. The blossoming of microbiology and cellular pathology in the 19th Century gave scientists the tools to truly understand how objects and dressings could be made sterile.
This led to the development of heat sterilization by Ernst Von Bergmann in 1886. Bergmann discovered that heat treated surgical instruments were far safer than their equivalents that had not been treated. From his discovery onwards, a sterile environment has been a key element of all wound care solutions.
Today, wound dressing materials are often synthetic. Materials such as silicone can be delivered in multiple perforated layers to emulate the protective power of skin.
Maggots & Leeches
In the 19th Century, leech and maggot treatments were in vogue. Leeches and maggots were thought to consume ‘bad’ blood and tissue, leaving the healthy tissue alone. Doctors would prescribe leeches and maggots for the cleaning of nasty necrotic wounds to prepare them for suturing.
As it turns out, the Victorians were right. Leeches and maggots are now widely used when treating chronic ulcers and nasty wounds.