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
After sterilizing the hands, the operator, the assistants, and nurses
should touch nothing which is not sterile. If they are obliged to do
so, the hands should be again washed.
Rubber gloves, such as are used in general surgery, are very useful in
the operations of gynecology. They may be worn to protect the patient
in case the operator or the assistants are not certain of the sterility
of their hands, or to protect the operator when working upon a septic
patient. Rubber gloves should be sterilized in the steam sterilizer.
=Sterilization of Dressings, Towels, etc.=--The operating-cloths,
aprons, sheets, towels, dressings, gauze pads, etc. are most
conveniently sterilized by steam heat. The temperature should be at
least 100° C. (212° F.). The dressings and bandages should not be
too tightly packed, so that all parts may be exposed to the same
temperature.
Several kinds of steam sterilizers have been introduced. The most
easily obtained is the Arnold sterilizer. An apparatus like the Sprague
sterilizer, in which the steam is superheated, is preferable, but, as
it is not portable, it is adapted only for hospital use.
The dressings should be maintained at the elevated temperature for an
hour or more. Although this method secures very good sterilization,
yet there are certain spores which resist such elevated temperature
even after a two hours’ exposure. The method of _fractional_ or
_discontinuous sterilisation_ has therefore been introduced. Two
or three successive sterilizations are practised at intervals of
twenty-four hours. Spores which at first escape destruction will have
developed into vegetative forms in the intervals, and are destroyed by
the final sterilizations.
At the Gynecean Hospital all dressings are sterilized for three
consecutive days for two hours each day. The dressings, towels, etc.,
after sterilization, should be preserved in sterile glass jars or other
sterile receptacle.
=Sterilization of Instruments.=--Instruments, drainage-tubes,
catheters, and any rubber appliance may be sterilized by boiling in
water for fifteen to thirty minutes. A dilute solution (1 per cent.)
of carbonate of soda is preferable, as the instruments are not so
easily rusted, and this solution, when boiling, has greater germicidal
qualities than plain water.
Very convenient instrument-sterilizers are made, in which the
instruments are contained in a tray that may be lifted out and placed
in the receptacle for containing the instruments during the operation.
This receptacle or pan should itself be sterilized, and should contain
sterile water, or preferably the sterile solution of bicarbonate of
soda, in sufficient quantity to cover the instruments.
It is very convenient to keep on hand a saturated solution of carbonate
of soda, sterilized by boiling, a small quantity of which may be
added to the water in the instrument-tray. Rusting of instruments is
diminished by this means.
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