A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
=Operating-room.=--The operating-room should be well lighted from the
top and at least one side. If a good natural light cannot be secured,
an electric drop-light will be found very convenient. For work deep
in the pelvis or the abdomen a good light is essential. If necessary,
light may be directed to the desired point by means of the ordinary
head-mirror.
The floor, walls, and ceiling of the room should be of some
non-absorbing material. There should be in the room no appliances
whatever that are not essential for the performance of the operation.
The interior of the room should be wiped throughout with a mop or
with wet cloths, or, still better, flushed with the hose, in order
to remove and lay all dust. The room may be wiped throughout with a
solution of bichlorid of mercury (1:2000). At the Gynecean Hospital the
operating-rooms are disinfected once a week with formaldehyd gas.
The temperature of the room should be not less than 75° F. Shock from
bodily loss of heat and exposure of the peritoneum is diminished if the
atmosphere of the room is at an elevated temperature.
=Apparatus.=--All apparatus, such as basins, tables, etc., should
be of such a character that it may be sterilized by boiling or by
washing with a solution of bichloride of mercury (1:1000). Glass-top
tables with painted or nickel-plated frames are preferable. The
operating-table should be so arranged that the patient may be placed
in the Trendelenburg position (Fig. 193). This position permits the
intestines to gravitate out of the pelvis, and is very useful in many
operations. There are a great variety of tables in use. Before the
Trendelenburg posture was introduced the writer used for several years
a plain hard-wood plank supported by two wooden horses. The Boldt table
is very convenient. With it there is no necessity for a rubber pad for
catching fluids. It is applicable for all gynecological operations.
Some operators are in the habit of dressing the operating table by
placing on it a blanket and sheet. This is unnecessary, unless the
patient is in such a condition of collapse that it is essential to
preserve all bodily heat. The blanket usually becomes saturated with
fluids and serves no good purpose.
The number and arrangement of the basins, tables, stands, etc. used in
an abdominal operation are shown in Fig. 194.
The basins are best sterilized by boiling, or by washing with scalding
water (inside and outside) and a solution of bichloride of mercury
(1:1000).
The tables and stands are sterilized by washing with the bichloride
solution. If wooden-top tables are used, they should be covered with a
towel wrung out of a 1:1000 bichloride solution.
[Illustration: FIG. 193.--Trendelenburg position.]
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