Pathology and treatment of diseases of women.

  • August Martin
Date:
1912
Catalogue details

Licence: In copyright

Credit: Pathology and treatment of diseases of women. Source: Wellcome Collection.

    63/500 (page 43)
    We must*consider for gynecologic purposes: 1. The skin of the abdo- men. 2. The skin of the external genitalia and the mucous membrane of the vagina. The abdominal skin is relatively smooth in the upper part and there- fore cleansed quite easily, but in the region of the hairy mons veneris, and in the inguinal folds it olfers a great obstacle to disinfection. The skin of the vulva and the mucous membrane of the vagina are still more inconvenient for disinfection. Both are rieh in folds and are always covered with all possible species of micro-organisms, offen also of a pathogenic nature on account of the nearness of the anus. The cleansing of these regions requires, therefore, especial care. The bowels are emptied regularly two days before Operation with castor-oil. The rectum is again thoroughly flushed on the morning of the Operation. Several full baths with soaping of the body provide for the prepara- tion of the abdominal skin, which is covered with a compress saturated in a 1: 2,000 Sublimate solution during the night before the Operation. Immediately before the Operation the abdomen, and especially the umbilicus, after careful shaving of the pubic hair, are thoroughly cleansed with water, soap, and brush, dried with a sterile towel and then rubbed energetically with sterile gauze sponges and tincture of soäp (Mikulicz) for five minutes. The bowels are also thoroughly emptied before vaginal operations. The field of Operation is prepared with soap sitz-baths for several days. The night before the Operation a compress, saturated in a 1:2,000 Sublimate solution, is placed over the vulva. The pubic hair is shaved previous to the Operation and the vulva and vagina are energetically cleansed with soap and water and finally irrigated with a Sublimate solution. Bumm recommends to rub the entire vagina and vulva with alcohol immediately before the Operation. Extremely dangerous and impossible to render sterile are the foci of infection when present in the genitalia. As such must be considered ichorous tumors (polyps, carcinoma), ulcers of the portio and so forth; they must be cleansed thoroughly with a sharp spoon, or if necessary cauterized on the day preceding the Operation. Mackenrodt recom- mends tamponing with 10 per cent. formalin gauze. Such foci, however, remain extremely dangerous and threaten success of the Operation in spite of all precautions. Disinfection of the Hands The cleansing of the hands of the operator is still more important than that of the field of Operation. While highly virulent organisms of infection are only rarely present on the skin of the patient, and that under pathologic conditions, the hand of the physician comes daily in contact with infectious material, pus, lochia, etc.