HAZARDS OF HYDROGEN-PEROXIDE IRRIGATION I N WAR SURGERY

Two cases of severe complications due to injection of hydrogen peroxid e under pressure into areas of muscular attrition in war wounds are re ported. In both cases the administration of hydrogen peroxide was asso ciated with tachypnoea, with major arterial desaturation and a precord ial ''mill-wheel'' murmur was heard. In one case, these symptoms were followed by hemiplegia caused by paradoxical arterial gas embolism, an d in the other case by a pulmonary oedema confirmed by computerized to mography. Both patients recovered under hyperbaric oxygen therapy. The release of gaseous oxygen under the effect of tissue catalase and the membrane peroxydasic activity of hydrogen peroxide initiate such comp lications. The injection of hydrogen peroxide under pressure into a cl osed or partially closed cavity should therefore be strictly prohibite d.