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
Appliances that are injured by moist heat or by steam may be sterilized
by thorough washing and soaking in a solution of bichloride of mercury
(1:1000). It is useful to keep a large vessel of such a solution on
hand, in which apparatus that is not injured by the bichloride may be
placed.
=The Water.=--The water used during the operation, for washing the
wound, the abdominal cavity, the sponges, and the hands of the operator
and assistants, should be sterilized by boiling or by distillation.
The water should be boiled for two hours a day on two consecutive
days, or it should be boiled under pressure as in some of the modern
water-sterilizers. If the water contain a perceptible sediment, it
should first be filtered.
Very convenient water-sterilizers are made, from which the water may be
drawn of any desired temperature, after having been both filtered and
sterilized by heat. There should always be a large quantity of sterile
hot water at hand. Water below the temperature of the body should not
be introduced in the peritoneal cavity, and pads brought in contact
with the intestines should be wrung out of hot water.
About fifteen gallons of sterile water are usually required in an
abdominal operation.
The water should be preserved in sterile pitchers, basins, or other
receptacles.
Glass flasks are very convenient for containing the water with which
the abdomen or pelvis may be washed out. The water may be poured
directly into the abdomen from the flask. The flask should be plugged
with non-absorbent cotton to prevent the entrance of dust.
Some operators prefer to use a normal salt solution (sodium chloride
gr. 90 to water ℥xxxiiiss) for washing out the peritoneum. Such a
solution is probably less irritating to the peritoneum than plain water.
If the flasks are used for containing the water, it may be boiled
in them, and then preserved by plugging with absorbent cotton until
required at the operation. The temperature of the water used for
abdominal irrigation should be 100° to 115° F.
=Sponges.=--In the minor operations about the vagina or uterus the
field of operation may be kept clean by irrigation with sterile water
or by the use of sponges. Small sponges in holders are commonly
used. These sponges, after being washed free of sand and bleached if
necessary, may be sterilized by soaking for twelve hours in a solution
of bichloride of mercury (1:500). They should then be rinsed in warm
water and preserved in a 3 per cent. watery solution of carbolic acid,
which should be changed every week.
Artificial sponges, or gauze sponges, are the most convenient in
abdominal surgery. They are cheap, and may be destroyed after each
operation, and they are very easily and certainly sterilized in the
steam sterilizer. Good marine sponges are so expensive that but few
operators destroy them after they have been once used. The cleansing
and sterilization of such sponges are tedious and uncertain. The gauze
sponges answer every purpose.
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