Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
Scarlet red ointment should be applied in the following manner: after
thorough cleansing of the part with tincture of green soap and water,
then ether and finally 93 per cent. alcohol, the ointment should be
spread in a thin layer over the entire surface on a piece of sterile
gauze, and over this an ordinary dry sterile dressing. If the ointment
is applied too thickly it may cause granulation tissue to break down,
and for this reason it should be spread in a thin layer upon the
granulating surface or its edges. Usually the dressing should be left
undisturbed for from 24 to 48 hours, then reapplied, as indications
warrant. The patient should invariably be informed that the dressing
will be stained red, so as to forestall unnecessary alarm, due to the
belief that a hemorrhage has occurred. He should also be apprised of
the fact that stains on the linen are hard to eradicate. In removing
the dressing, if it is adherent to the granulations, some peroxide of
hydrogen should be used to loosen it. The skin about the granulating
surface is best cleansed by benzine as this removes all traces of
scarlet red better than any other solution. The three formulas that
are recommended are the following:
Strength
Grains. Percent.
Scarlet red (medicinal Biebrich) 15 1
ungt. acidi borici q.s., ad. 3 ounces.
Scarlet red (medicinal Biebrich) 45 3
ungt.zinci oxidi q.s., ad. 3 ounces.
Scarlet red (medicinal Biebrich) 75 5
balsam Peru, 75 minims.
Petrolati q.s., ad. 3 ounces.
The first is indicated where its use is desired over a large area and
for a long time; the second, where an astringent action is required
because the granulations are profuse; the third, where the
granulations are sluggish and require stimulation.
The ointment in a 10 per cent. strength is not recommended because it
is too irritating.
In cases of chronic leg ulcers, especially those associated with
enlarged veins, it is impossible to effect a cure until the chronic
congestion of the limb is relieved and the blood supply of the part
approaches the normal.
Often all that is necessary is a gauze, muslin or flannel bandage,
properly applied over the dressing and extending from the ankle to the
knee.
A rubber bandage when applied with moderate, even pressure, has for
its purpose the relief of congestion, but in a great many cases the
rubber has an irritating effect on the skin.
Public-domain text, read in full here on John Shaqi.
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