Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo University Medical School, Oviedo, Spain; Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Spain.
Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medicine "San Giovanni di Dio" Hospital, Gorizia, Italy.
Injury. 2020 Mar;51(3):597-601. doi: 10.1016/j.injury.2020.01.046. Epub 2020 Feb 1.
Sir Martin Frobisher (ca 1535-1594), the famous Elizabethan explorer and privateer, sustained a bullet to the outer plate of his ilium from a low-velocity bullet wound fired at close range from an arquebus, an early form of musket. The bullet was removed, but he subsequently died from gas gangrene. This paper looks at the management of this injury in Tudor times and compares it to current practice. The arrival of gunpowder and the seriousness of the resulting injuries spurred innovation in surgical practice, such that at the time of Frobisher's death, the Tudor military surgeon had considerable expertise and skill. The wound, treated properly, was not serious, but his first surgeon failed to remove the wadding that the bullet took with it. This was recognised as an error at the time. A Tudor surgeon today would note that the surgical management has not really changed since their time, even though they did not understand infection and bacterial contamination. Guidelines on managing gunshot wounds, and most research, is focussed on high-velocity injuries where removal of foreign material (clothing) is mentioned. Low-velocity injuries are treated as "outpatients" and the importance of removing foreign material, especially when the bullet is left in situ, is not mentioned. The inexperienced surgeon of today risks making the same error as Frobisher's surgeon.
马丁·弗罗比舍爵士（约 1535-1594 年），这位著名的伊丽莎白时代探险家兼私掠船船长，曾被一支近距离发射的火绳枪（早期的一种滑膛枪）射出的低速子弹击中其骼骨的外板。子弹被取出，但他后来死于气性坏疽。本文探讨了都铎时代对这种损伤的处理方法，并将其与当前的做法进行了比较。火药的出现以及由此产生的严重伤害促使外科手术实践的创新，以至于在弗罗比舍爵士去世时，都铎时代的军医已经具备了相当的专业知识和技能。如果处理得当，这种伤口并不严重，但他的第一任外科医生未能取出子弹带出的填充物。当时就已经认识到这是一个错误。如果现代的都铎时代的外科医生会注意到，即使他们不了解感染和细菌污染，自那时以来，外科处理方法并没有真正改变。关于处理枪伤的指南和大多数研究都集中在高速损伤上，其中提到了去除异物（衣物）的问题。低速损伤被视为“门诊”，没有提到去除异物的重要性，尤其是当子弹留在原位时。今天经验不足的外科医生可能会犯与弗罗比舍的外科医生相同的错误。
