A manual of operative surgery / By Lewis A. Stimson.

  • Lewis Atterbury Stimson
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: A manual of operative surgery / By Lewis A. Stimson. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    the central ]X)rtions of tlie skin flaps to the underlyinfr raw sui'faces in the same manner. The outer surface of tlie skin sh«nihl not be ineludtMl in the l«x>p of such a suture, for the tension is apt to cause pain. If the skin is <k'licate tlie contact of muist sublimate dress- ings mav cause irritation, and it is well to use as a first laver a few tliicknesses of iodofomi gauze; over this are place<l the principal dressings, small cushions prepareil as above described. «:»r layei'S of gauze or cotton, arrange<l to make uniform pressure, and bound on witli bandages of antiseptic gauze, and over these is placed a large cushion or a thick sheet of prepared cotton. An impervious outside layer, oil silk or mackintosh, is no longer used: it has proved to be better to have the discharges (by by evajxjration. Open icounds are covered with a layer of two to four thicknesses of sublimate or iodofonn gauze, and then covere<l with the cushions or cotton or. if hollow, stuffed with crumpled c^auze. When the dressing is chanored the laver of gauze on the sui-face of the wound may usually be left in place. SUTURES. Sutures may be made of silver, silk, catgut, or horsehair. If a suture is to be retained for any length of time silver is the best material, since it does not provoke inflammation, and has but a slight tendency to cut out, unless tension is caused by inflammatory swelling. Silk answers equally well if it is to be retained for only a short time, and usually it can be removed with less pain and disturbance of the parts. If carbolized, and used in connection with the antiseptic dress- ing, it is as unirritating as silver. Catgut is unirritating and, if properly made and not too old, its buried portion will melt away in a few days. Horsehair is prepared by soaking in oil. which makes it pliable and diminishes its brittleness; it is useful when there is but little strain upon the parts, and when it is desirable that no marks shouM be left by the sutures. Sutures can hardlv be retained too lono^ a time if an ade-