Antiseptic surgery : its principles, practice, history and results / by W. Watson Cheyne.
- Watson Cheyne
- Date:
- 1882
Licence: Public Domain Mark
Credit: Antiseptic surgery : its principles, practice, history and results / by W. Watson Cheyne. Source: Wellcome Collection.
158/656 page 130
![]30 In future, the method of introducing strong carbolic acid into wounds by means of a piece of lint soaked in the undi- luted acid, held in dressing forceps, was adopted. The blood clots were as far as possible removed. In order to obtain a more substantial crust and one less likely to be detached, in cases where there was too little blood, a paste was made use of, composed of starch, moistened with carbolic acid placed outside a piece of calico soaked in pure acid, and applied next the wound. As a rule, however, there is enough blood to form a substantial crust if several layers of calico are used. A great risk of putrefaction was all along experienced, owing to the fact that the pure acid could not be made to overlap the skin around the wound because of the excoriation caused by it. This risk was especially great in the first twenty-four hours, during which there was a profuse flow of blood and serum. Hence attempts were made to obtain some sort of dressing containing the acid in a more diluted form, and the first-fruits of these attempts was the formation of various pastes, of which the chief was long known as carbolic putty. This consisted of a 1 in 5 solution of carbolic acid in boiled linseed oil mixed with common whiting (CaCOg), to the consistence of a firm paste or putty. This was then spread on a sheet of block tin, forming a layer of about a quarter of an inch in thickness. A piece of lint dipped in 1-5 oily solu- tion was retained permanently next the wound so as to prevent its exposiu-e during the changing of the dressings. The 'whole dressing was firmly fixed down by means of a continuous series of strips of plaster, which, however, were absent at the most dependent part, so as to allow the escape of discharge, which was received on a towel. After some time it was found better to apply this putty between two layers of calico, and then the block tin outside all. The advantages of this dressing are: the tin applied out- side prevents the escape of the carbolic acid, the acid in the putty is just sufficiently diluted not to excoriate the skin, while the paste serves as a reservoir- for the acid during the interval which elapses between the ehanging of the dressings, the dis- charge, as it flows out beneath the putty, taking up only a](https://iiif.wellcomecollection.org/image/b20409928_0160.jp2/full/800%2C/0/default.jpg)
