On the management of true and false capsules in ovariotomy / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: On the management of true and false capsules in ovariotomy / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    capsule. I packed the cavity very firmly with sterilised iodoform gauze, also applying pressure to the front of the wound, which was now closed. Not much blood was actually lost, as I promptly checked the haemorrhage whenever it occurred in the course of the operation. On the third day I removed the iodoform gauze, which was soaked with bloody serum. As oozing had ceased I did not pack again, but introduced a rubber tube into the cavity of the capsule. Here I must note that the packing caused no evil effect but one, namely, a very rapid pulse, due, I believe, to absorption of iodoform. Notwithstanding the severity of the operation the temperature only once reached 101°, and that was at the beginning of the first day after operation. There was no vomiting, abdominal tenderness, nor difficulty with flatus; yet on the second day the pulse ranged from 132 to 150. It fell at once when the gauze was removed, and on the fourth day stood at 90, which was slower than before operation. I should like to hear the opinion of the Society on iodoform-gauze packing. I employed it on this occasion because I knew that there was, and would be, free oozing, which had to be checked, whilst the exposed surface was septic. Pressure was necessary for a long period in order to stop the oozing, so that the gauze would inevitably become charged very soon with a quantity of serum already septic. I therefore deemed it right to make use of a true antiseptic—iodoform—so that it might disinfect the fluid retained in the gauze. A very rapid pulse when other symptoms are favourable is, according to my experience, a certain indication of poisoning by iodoform in any case where that compound has been freely used. Brettauer, of New York,* finds that there is also a rise of temperature; but wherever I have noted fever I have observed complications, such as retention of flatus, which have satisfactorily accounted for it. No doubt, then, simple sterilised gauze is best when- * See “ Iodoform Poisoning/’ ‘ Brit. Med. Journ., 1897, vol. i, p. 932.
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