The rules of aseptic and antiseptic surgery : a practical treatise for the use of students and the general practitioner / by Arpad G. Gerster.

  • Gerster, Arpad G. (Arpad Geyza), 1848-1923.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: The rules of aseptic and antiseptic surgery : a practical treatise for the use of students and the general practitioner / by Arpad G. Gerster. 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.

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    of a wound. Hence it is desirable to employ a liquid that, aside from its non-irritant quality, will have the property of extinguishing the noxious effects of those particles of dust that can not be washed away by the irriga- tion, but remain imbedded in the tissues. This is chemical sterilization. Different disinfecting solutions are used for this purpose to answer vari- ous requirements. Their composition and uses will be mentioned hereafter. Note.—Kiiramel, of Hamburg, has shown that a dustless operating-room can be had in a well-appointed hospital, and Neuber, of Kiel, has excellent results from operations done in such a dustless room, with well-cleansed hands, apparatus, and instruments, without the employment of antiseptic fluids. Even the dressings used are not impregnated with any antiseptic chemical, but are merely sterilized by being exposed to dry heat. No sponges are used, all blood being removed with a sterilized solution of common salt (6 : 1,000), which is absolutely unirritat- ing, and certainly forms the most gentle manner of cleansing a wound. H. RULES OF SURGICAL CLEANLINESS. 1. Hands.—The hands and forearms, especially the finger-nails, of the surgeon and his assistants should be well scrubbed in hot water with soap and brush for five minutes ; likewise the region of the body of the patient to be operated on after carefully shaving off the hair. After this follows an immersion of the hands in alcohol, and then in corrosive sublimate lotion (1 :1,000) for one minute. Note 1.—Kummel's recommendation of green soap (potash or soft soap) is excellent, on ac- count of its great solvent properties. Note 2.—Rings, especially those having stone settings, should never be worn by the surgeon or his aids in an operation. Bangles and bracelets of female nurses should not be tolerated. Every one's arms should be bared and scrubbed to the elbows. 2. The instruments should be subjected to a careful and minute cleans- ing with soap and brush, especial care being taken to remove dry particles of blood, pus, etc., from the grooves and behind the clasps of the more com- posite instruments, which ought to be taken apart each time for cleansing. Hollow instruments (trocars), or those that can not be taken apart, should be boiled in water for thirty minutes. They should be immersed for ten minutes in a three-per-cent solution of carbolic acid before use. Note.—The surgeon should learn to get along with as few instruments as possible. In selecting instruments, preference should be given to the most simple. The best instruments are those having smooth and well-polished surfaces ; grooved or roughened handles are hard to clean, and unnecessary. 3. Wound Irrigation.—During the operation the wound should be fre- quently irrigated with the proper kind of a disinfecting fluid ; the hands of the surgeon and his assistants should be also washed at not too long intervals in a disinfecting fluid (corrosive sublimate, 1 : 1,000) ; the instru- ments should be kept immersed in a three-per-cent solution of carbolic acid (which is the least injurious to them). The most convenient form of irrigator is the well-known fountain syringe of vulcanized rubber. Note.—Whenever any one of those engaged at an operation touches a not disinfected object —hands a chair, opens the window or door, helps the ana?sthetizer during a vomiting spell of the