The Medical journal of Australia
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Historical Article
The pivot: the First Australian Casualty Clearing Hospital at the Gallipoli beachhead--the first seven days.
In October 1914, a new type of medical unit was added to the order of battle of the Australian Army's casualty evacuation chain. Designated the casualty clearing hospital, it was called a Casualty Clearing Station on the beach at Anzac Cove in the Gallipoli campaign. This unit was established as the most forward unit to provide emergency surgery, freeing the forward field ambulances from the necessity of holding wounded soldiers, a task which compromised their mobility and prevented them from moving with the brigades they supported. ⋯ This paper reviews the first seven days of the Station's role at Anzac Cove, during which time this essentially inexperienced medical unit treated and evacuated an estimated 2700 wounded Australian and New Zealand soldiers. This paper also reviews the Commanding Officer's hitherto unpublished war diary and other archival and family records which add to the medical story of Anzac. This frightful baptism of mass casualty evacuation, undergone by the Australian Army Medical Corps, brings a perspective to the problems of mass disasters today.
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A retrospective study over an eight-year period of 33 episodes of leg ulceration in 26 patients with rheumatoid arthritis requiring inpatient management is reported. the aetiology of the ulcers was found to be multifactorial. The most common factors were venous insufficiency (45.5%), trauma or pressure (45.5%) and arterial insufficiency (36.4%). Vasculitis (18.2%) and Felty's syndrome (12.1%) were less frequent causes, and pyoderma gangrenosum was rare. ⋯ Skin grafting was required in 63.3%, but the rate of complete take was only 42.9% despite multiple attempts. Hospitalisation was prolonged (mean 47.9 days) and the recurrence rate requiring further hospitalisation was 26.9%. The diagnosis of vasculitis and the limited role of biopsy in establishing its presence are discussed.