A SURVEY OF WOUND INFECTION AT THE ROYAL MELBOURNE HOSPITAL

The principle involved in the artificial kidney is soundin theory, and the results described above indicate that it is effective in practice. But what are the dangersin this form of treatment? Obvious hazardsinclude the risks of hsemorrhage,either from some part of the body because of heparinization,or from rupture of the cellulose membrane in the machine; thrombosis and embolism; infection; untoward reactions to foreign blood; hssmodynamic disturbancesassociatedwith the imposition of an extracorporealcirculation; and biochemical mishaps through faulty concoctionof the dialysing fluid. Theseare very real, and the operatorsmust be continually on guard againstthem. With the aid of protaminesulphate,care in the sterilization of the blood-containingtubes, antibiotics, rapid and accuratebiochemical checksand, above all, an experienced team of operators, the dangers are considerably reduced,and are probably no greater than the risks to be run in the worsening ureemia of prolonged anuria or in the other conditions in which dialysis is indicated The only troubles encounteredin our series to date have been brief rigors, possibly due to pyrogens, in two of our early cases,and a small leak in the dialysing tubing in one other. As so often is the case with blood transfusion, so with dialysis; there are possible disadvantagesas well as advantages,and it is a matter for careful assessment whether the treatmentis indicated or not.