A System of Operative Surgery, Volume 4 (of 4) — John Shaqi
A System of Operative Surgery, Volume 4 (of 4)
Science
A System of Operative Surgery, Volume 4 (of 4)
Surgery, Operative
The preparation of the skin needs to be very thoroughly carried out.
After a warm bath the hair is shaved from the abdomen, pubes and vulva,
and the skin is well washed with warm soapy water and swathed in gauze
compresses wrung out of a solution of perchloride of mercury, 1 in
5,000. These compresses remain for twelve hours. The abdomen is again
washed, and a second compress is applied which remains on until the
operation.
Occasionally patients object to have the abdomen and pubes shaved. In
such cases the hair can be easily removed by a depilatory. I have found
a powder prepared according to the following formula useful:--
Sodium monosulphide, 1 part; calcium oxide, 1 part; starch, 2 parts;
sufficient water is added to make a stiff paste, which is spread over
the parts. After five minutes it is washed off by means of a dab of
cotton-wool and the skin freely washed with warm water. This preparation
is only efficacious when freshly prepared.
The washing and application of compresses require care on the part of
the nurse, for some patients have skin so tender that it is easily
blistered, and a crop of small pustules is a source of inconvenience,
and leads to stitch-abscesses. In certain cases over-preparation may be
worse than no preparation.
When patients are advanced in years it is extremely necessary to protect
them from being chilled by undue exposure. It is well to clothe their
lower limbs in warm flannel garments or drawers made out of Gamgee
tissue. No open doors or windows should be permitted; though in summer
this is comfortable to the surgeon it may be disastrous to the patient.
In winter the temperature of an operating-room should not be below 65°F.
In this way ether pneumonia is best avoided.
In operations, such as oöphorectomy, ovariotomy and hysterectomy, it is
the rule not to operate during menstruation; experience has taught me
that operations performed during this period are not followed by evil or
untoward consequences, and for many years I have disregarded it.
Immediately before the patient is placed on the table the bladder should
be emptied naturally, or by means of a sterilized glass catheter.
In all pelvic operations it is a great advantage to employ nurses who
have had a special training in ‘abdominal nursing’.
=Basins and dishes.= All receptacles such as basins, pots, instrument
dishes and the like should be boiled. Mere rinsing or washing in warm
water is insufficient.
=Instruments.= These should be constructed of metal throughout, as this
enables them to be thoroughly sterilized by boiling. Needles and
scalpels may be enclosed in perforated metal boxes. Forceps and the
handles of scalpels are nickelled, and this keeps them bright. The
following instruments are necessary: Scalpel, twelve hæmostatic
forceps, dissecting forceps, two fenestrated forceps which are also
useful as sponge-holders, a volsella, six curved needles of various
sizes, two straight needles, silks of various thickness, and six dabs.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account