Further report on aseptic and septic surgical cases : with special reference to the infection from the skin / by C.B. Lockwood.

  • Lockwood, Charles Barrett, 1856-1914.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Further report on aseptic and septic surgical cases : with special reference to the infection from the skin / by C.B. Lockwood. 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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    There was ultimately good union, and the man was able to return to work. In this case disinfection and asepsis were of the highest importance, as tissues deteriorated by continuous saprajmia are quite unable to resist septic processes. It is clear that the means which were relied upon in this and the previous case are not rigorous enough. The only other amputation from which cultures have been inoculated and which was septic was a Syme's amputation performed upon a boy of 12 years of age. Owing to unavoid- able circumstances the stump was dressed with double cyanide dressings, which, as in two other cases published in the Bbitish Medical Joubnal, 1890, vol. i, p. 1247, caused acute inflammation of the skin with the formation of large bullae. The dressing had therefore to be removed, and suppuration followed. Staphylococcus albus and streptococcus pyogenes grew in the inoculated tubes. The presence of the strepto- coccus was associated with some suppurative lymphangitis— an affection which it is said to cause. Superficial Infection. Case x. Removal of Tumour of Breast.—The following case is, I believe, a typical instance of infection of the wound by the skin. The patient was a married woman, aged 52, who had a doubtful tumour in the left breast. An incision did not clear up the doubt as to the malignancy of the tumour, and therefore it was removed without taking away the whole breast.6 The wound was dressed in the usual way, without drainage. The patient suffered from a neurotic affection, ac- companied with pains in various parts, but for some days after the operation she did not seem to have more pain in the breast which had been operated upon than in the other. On the eleventh day the wound was painful, and her tem- perature, which had been normal, rose to 99.6° F., and the tongue was foul, with loss of appetite. Next day the dress- ings were removed. The wound was healed except a small piece at one end where a little dark treacly blood exuded. Although the skin looked natural, there was beneath it a fluctuating swelling, from which a quantity of dark fluid blood was evacuated. This collection of blood was washed out with perchloride lotion, and drained, and speedily closed without suppuration. Gelatine tubes were inoculated from the healed part of the wound, and remained sterile; others inoculated from the unhealed part and from the blood grew a coccus with the characters of staphylococcus albus. But neither this original culture nor broth cultures inoculated from it seemed to cause ill effects when injected into the veins of rabbits. A microbe with identical characters was grown from the next case, and seemed decidedly pathogenic for rabbits. The history of the case was as follows : Case xi. Radical Cure of Hernia; Skin Infection.—S. C., a married woman, aged 45, had an irreducible femoral epiplo- cele on the right side. The usual operation for radical cure was done on February 2nd, and on February 11th the dress- ings were removed. Since the operation there had been no rise of temperature or pain or discomfort. The wound was healed, except at the skin level, where the epidermis had not 0 Hi is patient, was well nine months utter tho operation, although a his toiogical examination showed that tho growth was cancerous.