Licence: Public Domain Mark
Credit: The surgery of the head and neck / by Levi Cooper Lane. 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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![on the bauds which have been cleansed with soap and water, and to conclude by washing this off with sterilized water. The writer's plan is to scrub the hands well with soap and water, and then to rub them well with pure alcohol, or instead of alcohol, chloroform may be used as the final application to the hands. The operator should wear a rubber apron to protect his dress, and over this a sterilized linen or cotton gown sliould be worn. Instruments can be purified by inclosure in an oven or closed vessel, which is heated to a high temperature. The steel of instruments, however, is softened or changed by a high heat; hence other methods of sterilization have been introduced. That of Schimmelbusch is often used, which consist in immers- ing them in a strong solution of bicarbonate of soda, and boiling them in this for fifteen minutes. Another plan is to immerse the instruments in a four per cent solution of carbolic acid, and afterwards w^ash them in sterilized water. And during the operation the instruments may remain immersed in a twenty- five per cent solution of alcohol. The skin, especiall}' the hair and sebaceous follicles, are the special habitats of bacteria, hence dermal purification is a most important prcliminarv to an operation. And the first step in this is a general bath, in which the patient's body is cleansed with soap ai)d water. The part to be operated on is to be shaven, and then turpentine rubbed on it, and the work to conclude by diligently washing with soap and water. And if the pleural or ]-)eritoneal cavity is to be opened, besides the disinfection men- tioned, a soap poultice may be worn for twelve hours prior to the contemplated operation. The part to be operated on should be surrounded with sterilized sheets. The material for ligating vessels may be of silk or catgut. Silk can be sterilized by boiling it in water, or by prolonged immersion in alcohol. Catgut is sterilized in several ways: this may be done by boiling in alcohol, or by prolonged immersion in an alcoholic solution of corrosive sublimate, viz., one of sub- limate to five hundred of alcohol, and afterwards the thread is to be retained in alcohol. Some prepare it by treatment with formalin, and others with cnmol. Catgut may he hardened, and rendered less absorbable by boiling in a dilute solution of chromic acid in carbolized water. Silk-worm gut is used for external sutural closure. It is disinfected by prolonged immersion in ether, and it should be preserved in alcohol. Silver wire, or copper wire well plated or gilded, may be used for suture. Wire can be purified by immersion in boil- ing water, an-l it is best closed by twisting instead of tying. Unlike silk or catgut, metallic suture does not swell or enlarge in the tissues. If the dermal lips of the wound be too far asunder for sutural approximation, then the wounded surface should be closed by](https://iiif.wellcomecollection.org/image/b21215406_0033.jp2/full/800%2C/0/default.jpg)
