Robert E. Lempke

Studies in experimental frostbite. VII. An inquiry into the mode of action of rapid thawing in immediate treatment.

From the Department of Surgery, the Indiana University School of Medicine, Indianapolis, Indiana. Aided by a contract between the Office of Naval Research, Department of the Navy, and Indiana University and by a grant from the James Whitcomb Riley Memorial Association. Of all the methods of treatment which have been subjected to controlled study in experimentally induced frostbite, rapid thawing of the frozen extremity has proved to be by far the most efficacious. Its beneficial effect has been evident in experiments carried out in a variety of species (1) and has been confirmed by nearly all investigators (2, 3) who have studied the problem. It is, therefore, important that we learn as much as we can about the mode of action of this

Motility of gastric tubes

In gastric tubes interposed between small bowel a clear wave pattern was found, differing markedly from the bowl above and below. The gastric tube appears to be not an inert conduit since it continues to exhibit automatic rhythmic contraction. The possibility of slowing intestinal transit by the interposition of an antiperistaltic gastric tube seems to be supported by the demonstration of regular contraction.

Preoperative administration of fluids

A study by questionnaire was sent to 134 Surgical Services at Veterans Administration Hospitals to ascertain the prevalence of the practice of preoperative hydration during the period of hydropenia preceding surgery. A 92.5 per cent response was noted and the following conclusions are drawn: (1) The majority of Veterans Administration Surgical Services do not routinely provide intravenous fluids during the immediate preoperative period. (2) Affiliation with a medical school-based postgraduate training program does not alter significantly the proportion of Surgical Services providing preoperative intravenous therapy on a routine basis. (3) These observations suggest a need for Surgical Services to assess the desirability and indications of preoperative hydration. (4) However, in the case of chronic renal failure patients there is little question of the necessity for careful preoperative, intraoperative, and postoperative hydration.