Effect of local anaesthetics on wound healing - An experimental study with special reference to Carbocain

Recent research has improved the possibilities of assessing the influence of various factors on wound healing. Thus, PH. SANDBLOM (1944)(4), PH. SANDBLOM and A. MUREN (1953, 1954)(6,7) and B. ZEDERFELDT (1957)(8) and others have elucidated the effect of technical, local and physiological factors on the rate of healing of skin wounds. It has been shown (e.g. by B. ZEDERFELDT (1957)(8)) that various types of distant trauma retard healing, G. BJORLIN (1954)(2), who investigated the effect of local anaesthesia in the operative field, found this effect to vary considerably with the type of anaesthetic used. He also demonstrated considerable differences between a given anaesthetic solution with and without admixture of adrenaline. B. AF EKENSTAM et. al. (1956)(3) presented the results of the first clinical trial of a new local anaesthetic, Carbocain (R), belonging to a type of chemical compounds which had until then not been known to possess any local anaesthetic effect. It belongs to a group of cyclic acids with pipecolic acid as its acid component. The nitrogen in the piperidin ring is methylated and its aromatic component consists of a bond with the dimethyl analide, and its aromatic component is bonded to the dimethyl. The base is not readily dissolved in water, but is highly soluble and stable in aqueous solutions of hydrochlorides. As to the toxicity of the substance, B. AF EKENSTAM et. al. (1956)(3) found it to compare favourably with that of procaine and lignocaine. G. BJORLIN (1954)(2) found that the use of lignocaine retarded wound healing more than did procaine in corresponding concentrations. This difference was statistically significant. He also found that admixture of adrenaline to the anaesthetic solution delayed wound healing. The retarding effect of a local anaesthetic on the rate of wound healing can be taken as a measure of the local toxicity of the agent. The toxic effect may by composed of various components, such as a direct toxic action on the cells with disturbed scar formation as a, consequence, or vascular constriction in the region involved, with consequent ischaemia disturbing the healing process. The purpose of the present investigation was to assess the tissue toxicity of carbocain in comparison with that of procaine and lignocaine

Closed treatment of Jones fracture. Good results in 40 cases after 11-26 years

40 patients with transversal or short oblique fractures of the proximal shaft of the fifth metatarsal bone (Jones fracture) were treated with full weight bearing with or without elastic bandage in 39 cases and plaster cast immobilization in one. 24 cases were acute traumatic fractures, 14 stress fractures and 2 refractures. After 17 (11-26) years, 33 of the fractures had healed primarily, evidence of refracture or delayed union was found in 7 and there were no non-unions. All but one of the patients were free of symptoms