A letter from Alexis Carrel concerning the preantibiotic treatment of war wounds: The Carrel–Dakin solution

Abstract

The morbidity and mortality of soldiers injured during the First World War stemmed in large part from infections of battle wounds. Preventing and treating such infections was a major challenge for the medical corps. Alexis Carrel, a French-American surgeon, advocated irrigating open wounds with a hypochlorite solution (the Carrel–Dakin solution) to prevent the growth of bacteria contaminating them. His method of treatment was complicated and time consuming and was not well followed by surgeons who doubted the necessity of such an exacting protocol. In 1917, Carrel wrote a letter to an American colonel overseeing U.S. medical personnel soliciting his support in training American medical personnel in the proper use of the Carrel–Dakin solution. This letter was the stimulus for recalling here the opposition encountered by both Carrel and Joseph Lister, his predecessor in the aseptic–antiseptic treatment of open wounds, and for noting the conflicting views of contemporary surgeons over surgical sepsis.