Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
Recent investigations show that many germicidal substances have not
the power that was formerly attributed to them. Furthermore,
substances which are really active germicides very often produce a
marked toxic effect upon the patient and produce a very decided
irritation of the skin with which they come in contact.
+Aseptic Methods.+ The aseptic method for the treatment of wounds admits
of the use of germicidal solutions and heat upon the field of
operation, upon the hands of the operator and of his assistants, and
upon the instruments employed. After this has been accomplished,
placing absolute dependence upon this sterilization, no germicidal or
antiseptic substances are brought into contact with the wound,
sterilized salt solution or plain sterilized water being used, if
necessary, to flush the wound, the dressings employed having been
sterilized by dry heat or moist heat.
+Sterilization of the Hands.+ Experimental investigation has shown that
the failure of the surgeon’s efforts to render his hands absolutely
aseptic, has been the productive cause of infection in many wounds.
The hands and finger nails may be best sterilized by first rubbing
them with spirits of turpentine; then scrubbing them with soap and
water; and then using a sterilized nail brush freely. The scrubbing
should be done for several minutes. The hands should then be rinsed to
remove the soap, and then soaked for about ten minutes in a solution
of bichloride, strength, 1 to 2500. If turpentine has not been used
before washing with the soap, strong alcohol or ether should be well
rubbed over the hands before they are immersed in the bichloride
solution. Perhaps the best way of rendering the hands sterile is to
scrub them with green soap and water, then mix a tablespoonful of
commercial chloride of lime and half a tablespoonful of carbonate of
soda with enough water to make a paste. When this has assumed a thick
creamy consistency, it should be rubbed into the hands until the
grains of lime disappear and the skin feels cool; then rinse the hands
in sterile water.
+Sterilization of Instruments.+ Instruments may be sterilized by
boiling them for fifteen minutes in water in which a tablespoonful of
washing soda has been added for each quart. This prevents rusting of
the instruments and also makes the water a better solvent for any
fatty matter which may be upon the instruments, thus increasing the
sterilizing effect of the heat.
+Sterilization of the Feet.+ As most patients do not apply water as
freely or as frequently to the feet as to other portions of the body,
there is usually present an excessive amount of thickened epidermis,
which is very difficult to render sterile. For operations in chiropody
the feet should be thoroughly moistened with soap and water, scrubbed
vigorously with a brush, then soaked in a solution of bichloride of
mercury of 1 to 1000 strength, and then wrapped up in a towel soaked
in the same solution while waiting for the operator.
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