Manual of Surgery Volume First: General Surgery. Sixth Edition.Thomson, Alexis
Science
Manual of Surgery Volume First: General Surgery. Sixth Edition.
Thomson, Alexis
Surgery
An occlusive dressing of melted _paraffin_ has also been employed. A
useful preparation consists of: Paraffin molle 25 per cent., paraffin
durum 67 per cent., olive oil 5 per cent., oil of eucalyptus 2 per
cent., and beta-naphthol ¼ per cent. It has a melting point of 48° C.
It is also known as _Ambrine_ and _Burnol_. After the burned area has
been cleansed and thoroughly dried, it is sponged or painted with the
melted paraffin, and before solidification takes place a layer of
sterilised gauze is applied and covered with a second coating of
paraffin. Further coats of paraffin are applied every other day to
prevent the gauze sticking to the skin.
An alternative method of treating extensive burns is by immersing the
part, or even the whole body when the trunk is affected, in a bath of
boracic lotion kept at the body temperature, the lotion being frequently
renewed.
If a burn is already infected when first seen, it is to be treated on
the same principles as govern the treatment of other infected wounds.
All moist or greasy applications, such as Carron oil, carbolic oil and
ointments, and all substances like collodion and dry powders, which
retain discharges, entirely fail to meet the indications for the
rational treatment of burns, and should be abandoned.
Skin-grafting is of great value in hastening healing after extensive
burns, and in preventing cicatricial contraction. The _deformities_
which are so liable to develop from contraction of the cicatrices are
treated on general principles. In the region of the face, neck, and
flexures of joints (Fig. 63), where they are most marked, the contracted
bands may be divided and the parts stretched, the raw surface left being
covered by Thiersch grafts or by flaps of skin raised from adjacent
surfaces or from other parts of the body (Fig. 1).
INJURIES PRODUCED BY ELECTRICITY
#Injuries produced by Exposure to X-Rays and Radium.#--In the routine
treatment of disease by radiations, injury is sometimes done to the
tissues, even when the greatest care is exercised as to dosage and
frequency of application. Robert Knox describes the following
ill-effects.
_Acute dermatitis_ varying in degree from a slight erythema to deep
ulceration or even necrosis of skin. When ulcers form they are extremely
painful and slow to heal. When hair-bearing areas are affected,
epilation may occur without destroying the hair follicles and the hairs
are reproduced, but if the reaction is excessive permanent alopecia may
result.
_Chronic dermatitis_, which results from persistence of the acute form,
is most intractable and may assume malignant characters. X-ray warts are
a late manifestation of chronic dermatitis and may become malignant.
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