Statistical report of the major operations performed by Professor Spence in the Edinburgh Royal Infirmary / by George Kirkwood ; with remarks by Professor Spence.

  • Kirkwood, George.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: Statistical report of the major operations performed by Professor Spence in the Edinburgh Royal Infirmary / by George Kirkwood ; with remarks by Professor Spence. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    1 by its absorption might give rise to serious constitutional disturbance. In order to effect these objects, all wounds wliich are deep and dis- charging freely are dressed twice a day at least, and at cadi dressing the wound is syringed out very gently Avith a solution of carbolic or boracic acid, used of a strength Avhich gives rise to no irritation of the wound. So soon as the Avound begins to granulate, in addition to cleansing it thoroughly, some stimulant lotion is used, such as a solution of chlorinated soda (one part liquor to twenty parts Avater) or sulphate of zinc (two grains to the ounce). Clean dressings are ajAplied each time the Avound is dressed. Before stitching up a Avound at an operation, the surface is freed from small clots and thoroughly Avashed by jiouring over it tejiid Avater to Avhich a verj’ little carljolic acid has been added. After the Avound is closed by sih’er sutures, a piece of Avaxed paper is applied over it as a protective, and a thin layer of oakum (held in position by a bandage or put in a single fold of lint) is placed outside the Avaxed j)aper. Care should he taken that the oakum does not touch the skin, as it gives rise to a considerable amount of irritation. In* the case of stumps, after apjilying the Avaxed paper, a single ply of lint is brought over the end, so as to support the flaps, and this is kept from slii)ping, and at the same time lateral support is given to the stump, by means of a fold of lint encircling the stump, and containing a layer of oakum betAveeii its folds. In order to give mon^ thorough support to the flaps and ])revent them retracting, a bandage applied from above doAvn may be used before the dressing is put on. The stump is laid on oakum, and oakum is put loosely over the end, and if this dressing be properly applied, the stump can la* looked at Avithout raising it from the bed. In the evening, after an operation, the Avound is syringed out, and all clots removed, a stitch being taken out at the angles of the Avound, if necessarj’’, to alloAv of this being done. Gi'eat care is ahvays taken that the dis- chargt> gets freely aAvay; anil for this ]niq)ose some stitches are removed at the most dependent i>art of the Avound very soon after an operation. By this means the serous discharge at first, and sub- sequently the pus gets free vent, and bagging of the end of a stump or abscess in the limb aboA'e is preA'ented. A small piece of drainage tubing introduced IjctAveen the edges of the Avound still further favours discharge by keeping the lips from closing at that part. AVhen granulation is going on, instead of using the Avaxed paper, a strip of lint soaked in a stimulating lotion and applied to the Avound often proves of great service in the healing process. When the granulations are strong and healthy this may not bo required, aud under these circumstances ■ the use of the waxed paper may be con- tinued. Should redness appear at the edges of a AVOund, stitches Avhich seem to be giAung rise to tension are at once removed, and strips of