Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
The stronger acids are employed for their escharotic qualities.
“Red wash” (made up from the following formula: zinc sulphate 20
grains, compound tincture of lavender 30 minims, distilled water to
make 8 ozs.) has a powerful astringent action and promotes
cicatrization, especially when there is a tendency for the
granulations to become exuberant.
In the treatment of chilblains, a strong astringent is desirable to
constrict the diluted capillaries.
The stronger _lotio alba_ of the national formulary, containing equal
parts of the saturated solutions of zinc sulphate and potassium
sulphuret, is markedly astringent and has a drying effect upon the
skin.
+STYPTICS+
+Styptics.+ These may act either by causing clot formation in the cut
arteries, or by causing the retraction of their edges. In the latter
class are included such drugs as _hydrastine_ and _adrenaline_.
The disadvantage of using these drugs lies in the fact that secondary
hemorrhage is possible when their constrictor action is over. The
styptics causing clot formation are therefore to be recommended. They
should be non-irritating, antiseptic, and styptic, at the same time.
Such a preparation is practically unknown.
_Peroxide of hydrogen_ on a pledget of cotton, placed over the
bleeding area, may effect a clot formation.
The U.S.P. _liquor ferri subsulphatis_, better known as Monsel’s
solution, is the best and most effective styptic that we have.
Monsel’s solution, however, is not antiseptic and entrance of bacteria
into the wound is possible, unless, it is applied with a sterile
applicator or is dropped directly upon the wound from the bottle.
The U.S.P. _tincture of iodine_ in equal parts of water, applied to
the bleeding area may, besides sterilizing it, stop bleeding.
Should none of the above effect a stoppage of the bleeding, other
means must be sought. A bit of sterile gauze pressed quite firmly
against the area, should next be tried. If this fails, a wooden
applicator, prepared with Monsel’s solution may be employed. A cotton
wound applicator, unless dipped into a strongly antiseptic solution,
contains millions of bacteria from the fingers. The use of the ancient
styptic stick of alum, copper or silver is discountenanced everywhere
as uncleanly.
+SOLVENTS+
+Solvents.+ Under this heading, those substances which are known to
soften tissue will be considered.
_Sodium hydroxide_, up to a saturated strength, or an ointment of
_salicylic acid_, 5 per cent. to 50 per cent., depending upon the
density of the tissue to which it is applied, are the ones commonly
used.
These two drugs have the power to macerate dry, hard tissues.
Experience is necessary for the proper use of tissue solvents as the
length of time that they are allowed to act is of as much importance
as the strength of the solution.
Sodium hydroxide solution can be instantly neutralized with any acid
and for this reason is preferable.
+OINTMENTS+
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