Licence: Public Domain Mark
Credit: Surgery / by John Allan Wyeth. 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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![Asepsis implies the alisence of infective organisms from the tissues; antisepsis, the effort to destroy those already present. When it is ]aioT\'n that cell proliferation in the process of repair in a ^vo^md from which septic organisms are excluded (or in which their proliferation is pre- vented) does not differ materially from the original development of the tissues in embryo, the vast importance of asepsis is evident, and while cleanliness is not all that is necessary to secure the best possible result in the healing of a wound, it is of sufficient importance to deserve the most careful consideration. It follows that not only should the atmosphere of the room and all materials brought in contact with the wound be germ-free, but that the operator and all assistants should carefully sterilize the hands and prevent the possibility of infec- tion from their person or clothing. In cleansing the hands the nails should be trimmed closely, and, even if short, should always l^e freshly clipped. Three basins, which have just been taken from boiling water and placed on a table covered with a sterile cloth, should be filled with a—1-1000 mercuric-chloride solution, colored hliie to prevent error.^ h—Water that has been boiled, or warm sterile salt solution (one tablespoonful of salt to one pint of water). c—Clear water that has been boiled and is quite warm, soft soap that has just been boiled and allowed to cool, and a brush and nail cleaner taken from the boiler for each basin. Soak the hands for several minutes in the soap-and-water solution, rubbing them and the forearms thorotxghly ^ith the lathered brush, rinse and brush in the sterile salt solution, and cleanse thoroughly beneath the nails with a cleaner. Brush the hands again in the soap-and-water solution, then in the sterile salt solution, and next soak them from three to five minutes in the 1-1000 mercuric chloride. This being done, it is advisable until the operation is commenced to protect the hands at once from accidental contact with an unsterilized material by putting on a pair of sterile hop-picker's gloves. Tight-fitting ntblser gloves of smooth or rough surface, which may be thorotighly sterilized by boiling, are a valu- able addition to modern teclinic. It is my preference to wear these as a protection to the hands imder septic conditions and to use the hands free in clean surgery. To the general practitioner, who of necessity frequently subjects his hands to con- tact with infectious material, it is advisable to use sterilized rubber gloves in all operative work. Once in contact with septic material, these should be thor- oughly washed on both sides, first under running warm water and then with brush and soap and warm water, and finally boiled by being placed in tepid water gradually heated to the boiling point. Upon cooling sufficiently they should be wrapped in a sterile towel and put aside, to be boiled again just before the next operation. The operator and first assistant should be protected with a clean rubber apron and over this a full-length sterile operating gown, preferaljl}' with long sleeves, coming within eight inches of the wrist. If they be bearded or mustached, these and the face and hair should he ren- dered aseptic by bathing in 1-1000 mercuric-chloride solution. The hair should be covered with a sterile cap, and in all serious operations it is advisable to wear a veil of gauze over the nose, mouth, and beard. Every few minutes during the operation the surgeon should rinse his hands with a 1-1000 mercuric-chloride solution, wiping them dry ■«'ith a sterile towel before touching the wounded surfaces. This practice protects both patient and surgeon from infection. Should the operator be especially susceptible to the irritation of the merctiric solution, it may be weakened to 1-2000 or 1-3000. All material brought in contact with or near the wound should be absolutely sterile. 1 One grain to one ounce is approximately 1-500. One commercial tablet to one pint of warm water is 1-1000.](https://iiif.wellcomecollection.org/image/b21203647_0015.jp2/full/800%2C/0/default.jpg)
