Antiseptic surgery : an address delivered at St. Thomas's Hospital : with the subsequent debate to which are added a short statement of the theory of the antiseptic method, a description of the materials employed in carrying it out, and some applications of the method to operations and injuries in different regions of the body, and to wounds received in war / by William MacCormac.

Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Antiseptic surgery : an address delivered at St. Thomas's Hospital : with the subsequent debate to which are added a short statement of the theory of the antiseptic method, a description of the materials employed in carrying it out, and some applications of the method to operations and injuries in different regions of the body, and to wounds received in war / by William MacCormac. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    kept ready in a two-and-a-half or three-per-cent. solution, which may be also used for washing the wound and the sponges. All bleeding points must be carefully secured, either by torsion, carbolised gut, or carbolised silk, the ends being cut short. Too much time can scarcely be devoted to the complete arrest of haemorrhage. The sutures should be both deep and superficial; the former of wire, the latter of catgut, and if there be tension, the button-suture is useful —a simple form consisting of leaden plates, through which the wire passes. The entire surface of the wound should, if possible, be brought into apposition. Drainage-tubes should be inserted, in order that the bloody serum which exudes may easily escape externally, without producing tension or separation of the wound-surfaces, as well as because of its proneness to decompose. The principle on which these act is to carry the secretion from the deeper parts of the wound, as well as from any irregularity or recess, by the straightest shortest road to the surface. Therefore, they ought to be of sufficiently large calibre. Many short drains, rather than few and long ones, are preferable. They should be removed so soon as their function is at an end—in many cases, at the end of three or four days, and always before they set up irritation, or act as foreign bodies. Thus used, drainage is of the first importance : it is primary and preventive. The drainage-tubes of Chassaignac served a different object: they were intended to provide for the escape of matter already formed, and might be called secondary drains. A sufficient number of tubes having been inserted, the projecting portions are cut off level with the surface, and a layer of protective silk applied to the wound. Over this are placed several layers of carbolised gauze, wrung as dry as possible out of a two- and-a-half-per-cent. solution of carbolic acid, and fastened to the surface with a carbolised bandage. Over this again may be applied a layer of salicylic wool. It exercises an elastic