Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
The mass after having been molded in the shape desired may be further
hardened and set by the application of ice cloths or spraying with
ether before the needle is withdrawn from the skin, yet this is hardly
necessary, and the author advises against the practice for the reason
that pressure of the needle prevents proper and free molding of the mass
and renders the tissue liable to further injury by scraping its point to
and fro subcutaneously, adding to the extent of the wound and the dangers
of infection and repair.
The skin immediately around the needle hole, after withdrawal of the
needle, may be gently smoothed out with the dull rounded metal handle end
of the bistoury to free the interdermal canal of any foreign matter.
The skin about the needle hole is then gently washed with a
fifty-per-cent solution of hydrogen peroxid, dried with a sterile cotton
sponge and the opening sealed with a drop of collodion. Subsequent
treatment of the parts will be considered later.
=14. Solidification of Paraffin in Needle.=—This occurs only when
paraffins of high melting points are employed in liquid form in the
syringe, and is due to the rapid cooling of the paraffin in the small
metallic cannulæ, or needle, wherein it sets more readily, since the
volume contained therein is very small, often not more than two or three
drops.
This cooling establishes a pluglike formation in the distal end of the
needle, which prevents a proper use of the syringe, often breakage, and
when suddenly liberated by an extra pressure on the piston rod causes a
rapid discharge of the contents of the syringe to an extent not desired
with the result of hyperinjection.
This fault was one of the most annoying in the early days of such
injections when syringes of ordinary pattern, such as the Pravaz, or
those built like the ordinary hypodermic, were used. It was not unusual
to have the paraffin cool in the needle so quickly between the latter
in the flame of an alcohol lamp that the syringe became unmanageable
and broke in the hands of the operator. Since that time new and more
useful syringes have been introduced by various operators which overcome
this difficulty, yet with them, too, come the employment of semisolid
paraffins or mixtures thereof. Yet, as some authors insist upon using
paraffins of high melting points, it may be well to rehearse their
methods of overcoming this annoying intraneedle solidification.
Eckstein surrounds the syringe and needle shaft, except the tip of
the needle, with a rubber tubing, as shown in Fig. 284, to act as an
insulator, and thus, for a time at least, keep the preparation liquid.
Before filling the syringe he heats it by several immersions in and
internal washings of hot sterile water. To prevent the paraffin from
setting in the exposed tip of the needle he draws into the filled syringe
a few drops of hot water, which are injected into the tissues, causing no
objection to the method.
Public-domain text, read in full here on John Shaqi.
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