Pathology and treatment of diseases of women.

  • August Martin
Date:
[1912]
Catalogue details

Licence: Public Domain Mark

Credit: Pathology and treatment of diseases of women. 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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    wormgut, linen thread, silver and bronze wire are boiled with the in- struments before being used. Many methods have been recommended for the sterilization of catgut. Unless they kill anthrax-spores, they are useless. The cumol catgut after Kroenig, which is distributed by the firm of Dronke, Cologne, is to be recommended as quite excellent, safely sterile, of great tensile strength and also on account of the handy form in which it is sold. We have used it exclusively for years with the best results. Iodin catgut is also spoken of very highly of late. The selection of suture material is for a great part a matter of per- sonal inclination and experience. We have employed catgut for some time for all suturing in the abdom- inal cavity, with the exception of intestinal suturing, which is done with silk. It is also used in all plastic operations on the vagina, and for all buried sutures. We use the cheap and durable aluminum-bronze wire for suturing the fascia, as well as the external skin of the abdomen and the genitalia (vulva, perineum), and for operations on fistulas. [For many years I have used the plain and chromic cumol catgut as prepared by Van Horn & Sawtell, New York. It is prepared in differ- ent sizes. For peritoneal suturing I use No. 0 20-day chromic catgut; for the fascia, a No. 1 20-day chromic catgut; for the muscle, a No. 1 plain catgut; for the cervix, vagina, perineum, and rectum, a 40-day No. 1 or 2 chromic catgut; for the mucous membrane of the rectum and for coaptation of the muscles of the perineal body, a No. 0 or No. 1 40-day chromic catgut. Catgut sutures are always used double. The tissues will absorb two fine strands more readily than a single heavy one. For intestinal work I use silk sutures; for skin, horsehair. Silkwormgut retention sutures are used in the closure of all abdominal incisions and perineorrhaphies.—Ed.] The water used in solutions for cleansing the hands, making infu- sions, etc., should be boiled for a quarter of an hour. It is thereby ren- dered germ free. With sufficient patience and care there should be no longer, at the present day, any difficulty in carrying out these measures of asepsis. Disinfection of the Field of Operation The following fact must be placed at the beginning of this section as the leading proposition: It is impossible with the present means to render the human skin absolutely sterile. However, by careful preparation, an elimina- tion of germs sufficient for practical purposes can be obtained. A different preparation must be made for the various regions of the skin.
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