Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
=Iodoform= (_Formyl Iodid_, _Féréol_).—A lemon-yellow crystalline powder
of penetrating, saffronlike odor. Contains ninety-seven per cent iodin.
Insoluble in water, but forms solution with alcohol, ether, chloroform,
and the fixed volatile oils. Has a decided stimulating effect on wounds
by preventing putrefaction and deodorization (Mikulicz). Its antiseptic
value has been much discussed, but practically it has found favor with
the majority of surgeons. According to research, iodoform is a powerful
antiseptic, from the fact that the product of its decomposition in
the presence of germ life renders the ptomains in a wound inert, thus
preventing suppuration, or at least checking the absorption of such,
which is often a serious matter in infected wounds. It is not sterile,
and may contain ptomains which in themselves would produce pus, but as
associated with the iodoform do not occasion it.
CHAPTER V
WOUND DRESSINGS
The dressing or treatment of wounds, considered herein, embodies
particularly that practiced by the surgeon in the performance of plastic
operations.
The elasticity of the skin is especially serviceable in bringing about
desirable restorative results, but, owing to its extreme vascularity
and the infrequent supply of venous valves, as in the face, there
is considerable danger of infection, with rapidly spreading septic
inflammation.
=Sutured Wounds.=—Before the wound is closed all hemorrhage must be
arrested, either by catgut ligature, in exceptional cases, and by torsion
or pressure, as generally practiced. Gauze sponges dipped into hot
sterilized solution are most suitable for the latter purpose.
The edges of the wound must be coapted perfectly by cutaneous sutures
of sterilized silk of suitable thickness. Formaldehyd catgut is often
used because of its limited absorption. Ordinary catgut should not be
employed, as its early absorption interferes with obtaining the proper
union, and by becoming softened invites sepsis.
The wound, if small, may be powdered over with any of the antiseptic
powders, such as aristol or iodol. It must be remembered that such
powders form a hard crust with the serous oozing of wounds, which, by
reason of pressure from the dressing applied over it, is very liable to
separate the edges of the wound, thus increasing the width of the scar, a
very important factor in facial surgery.
Where perfect apposition has been made, the dusting powders may be used
and a covering of Lister’s protective silk plaster placed over it. The
edge of the strips of plaster must be incised at distances of about ⅛
inch, so as to snugly take on the curvature of the parts and at the same
time thoroughly seal over the area to prevent subsequent contamination.
The plaster is made of taffeta silk, preferably of flesh color, coated on
one side with copal varnish and a mixture prepared as follows:
℞ Dextrin ʒj;
Starch ʒij;
Carbolic acid ℥ij.
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