Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
Any of the above methods are not above criticism, however, rigid as they
may seem, bacterial growths having been obtained with nearly all of them.
The _dry-air method_ (Boeckman, Reverdin) is reliable, but the subjection
of catgut to dry air at a temperature of 303° F. for two hours results in
making it tender and less pliable.
[Illustration: FIG. 20.—CLARK KUMOL APPARATUS.]
The _Kumol method_ (Kronig) is considered the most reliable, even under
the severest tests. This mode of sterilization is accomplished as
follows: A specially devised apparatus of brass, with a cast-bronze top,
both thoroughly nickel-plated, is used. The apparatus of J. G. Clark, as
shown in Fig. 20, will be found excellent. The kumol is retained in a
seamless cylinder, 8 by 8 inches, which is surrounded on the sides and
bottom by a sand bath; the flame, impinging on the bottom, heats the
sand, thereby insuring an even heat to the inner or sterilizing cylinder.
The catgut, in rings, is placed in a perforated basket hanging in the
cylinder, which can be raised or lowered at will; after drying for two
hours at 80° C., the basket is dropped, and the catgut immersed in the
kumol, at 155° C., for one hour; the kumol is then drawn off through a
long rubber tube, and the catgut dried at 100° C., for two hours; it is
then transferred to sterile glass tubes plugged with cotton.
_Prepared catgut_ of the various sizes can now, however, be purchased in
the market, and that offered by the better firms of chemists is quite
reliable and may be safely used for all plastic surgery about the face.
It is supplied in glass tubes, either in given lengths, as in the Fowler
type, in which the hermetically sealed tube is U-shaped or on glass
spools placed in glass tubes, not sealed, but closed by a rubber cap,
through which the desired length of ligature is drawn and then cut off.
CHAPTER IV
PREFERRED ANTISEPTICS
ANTISEPTIC SOLUTIONS
These are solutions used for the destruction of and to arrest the
progress of microörganisms that have found their way into wounds—the
cause of sepsis, as exhibited by fever, suppuration, and putrefaction.
These preparations are called antiseptics and are used to render parts
aseptic. They vary much in their destructive power, effect on tissue, and
toxic properties. The reader is referred to a work on bacteriology for
the specific knowledge of such on germ life.
The antiseptic treatment of wounds was founded by Joseph Lister, 1865-70,
then called Listerism. His one chemical agent to accomplish this was
carbolic acid, but many such and more effective agents have been added
since that time, all differing in their specific properties and each
having, for the same reason, its particular use.
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