Licence: In copyright
Credit: Manual of surgery / by Alexis Thomson and Alexander Miles. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![1000 sublimate solution. It is then wound on to spools with purified hands protected by sterilised gloves, and kept in abso- lute alcohol. Before an operation the silk is again boiled for ten minutes in the same solution, and is used directly from this (Kocher). Linen or celluloid thread is sterilised in the same way as silk. Horse-hair, li.shing-gut, and silver wire, as w'ell as the needles, should be boiled along with the instruments. The field of operation is surrounded by macintoshes covered over with sterilised towels, securely fixed in position so that no contamination may take place from the surroundings. The surgeon and his assistants, including the anesthetist, should wear overalls sterilised by steam. To avoid the risk of infection from dust, scurf, or dro])S of perspiration falling from the head the surgeon and his assistants should wear sterilised cotton caps. It has been shown that there is considerable risk of infection taking place by drops of saliva projected from the mouth in talking or coughing in the vicinity of a wound. To obviate this risk a simple mask should be worn. The risk of infection from the air is now known to be very small, so long as there is no excess of dust floating in it. All sweeping, dusting, and disturbing of curtains, blinds, or furniture must therefore be avoided before or during an operation. It has been shown experimentally that the presence of spectators increases the number of organisms in the atmosphere. In teaching clinics, therefore, the risk from air infection is greater than in private practice. To facilitate primary union, all hemorrhage should be care- fully arrested, and the accumulation of fluids in the wound prevented. When much oozing of serum or blood is antici}>ated, a glass or rubber drainage-tube should be inserted through a small opening specially made for the purpose.. In aseptic wounds the tube may be removed in from twenty-four to forty- eight hours; in infected wounds it must remain as long as the discharge lasts. The edges of the wound should be brought into accurate apposition by sutures. If any cavity exists in the deeper part of the wound, it should be obliterated by buried sutures, or by so adjusting the dressing as to bring its walls into apposition. If our precautions have been successful, the wound will heal under the original dressing, which need not be interfered with .for from ten to fourteen days according to the nature of the case. Dressings.—Gauze, either sterilised by heat, or impregnated](https://iiif.wellcomecollection.org/image/b21933194_0001_0065.jp2/full/800%2C/0/default.jpg)
