A guide to the aseptic treatment of wounds / by Dr. C. Schimmelbusch. Preface by Prof. E. von Bergmann. Tr. from the 2nd rev. German ed. with express permission of the author / by Frank J. Thornbury.

  • Curt Schimmelbusch
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A guide to the aseptic treatment of wounds / by Dr. C. Schimmelbusch. Preface by Prof. E. von Bergmann. Tr. from the 2nd rev. German ed. with express permission of the author / by Frank J. Thornbury. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    219/256 (page 199)
    3. Necessity for removal of the drainage tubes. 4. Evidence of infection. Secretions of fresh wounds are taken up very well by dressings composed of gauze and moss. When the secretions penetrate to the up])er surface of the dressings it suffices for preserving the aseptic character of the latter to apply addi- tional layers of gauze, or simply provide for the contact of the air with the saturated areas. The object of the latter is to cause them to become dried. When the entire dressing is saturated with discharge the upper layer should be removed, the deeper remaining undisturbed. Frequent changes are necessary in ichorous and offensive wounds, because even the gauze absorbs with difficulty the tenacious pus, and the latter stagnates under the dressing. Here a change, at intervals of twenty-four, forty-eight, or seventy-two hours, is required. Especial precaution must be taken against outward soiling of the dressing in regions of the rectum and genitalia. When in the latter situation the gauze and bandage become saturated with urine or soiled with faeces, this portion must be removed. In the von Bergmann Clinic the drainage tubes are removed on the sixth or eighth day. As a rule, union is then complete, so that the greater number of sutures can be dispensed with. The drainage tubes are removed in toto at one time, and not gradually shortened. The small fistulous tracts remaining, close in the course of a fev/ days. The presence of the tube after the end of a week is unnecessary, it having at this time no further function to perform, and it prevents the complete closure of the wound. It must not be supposed, however, that a tube left for a longer time would be a source of danger. Through error this once occurred in the von Bergmann Clinic, a drainage tube being allowed to remain for five weeks, and, notwithstanding, no particular disturbance was occasioned. After its removal the wound healed rapidly throughout its en-