Surgery, with Special Reference to Podiatry — John Shaqi
Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
A superior styptic has been supplied in the form of dry subsulphate of
iron fused to small sticks of wood. These are efficient because of
their cleanliness, each being used but once and at no appreciable
expense.
It is needless to say that the dressing of even so slight a wound
should prevent the admission of infection to the thousands of portals
of infection which are present. A bandage is not indicated nor
justifiable, and the cotton collodion cocoon suffices.
+Persistent Bleeding.+ When bleeding occurs which does not yield to the
effects of a styptic because of its constant washing away when
applied, it becomes necessary to apply pressure to the wound.
Frequently a wad of cotton or gauze, pressed firmly upon the bleeding
area, will almost stop the bleeding in a few minutes, after which it
becomes possible to apply the styptic. Should this, however, be found
impossible and the bleeding resume when the pressure is released,
clotting in the vessel can only be expected by the agency of either
ligation of the tissue or any individual vessel or more commonly by
tight bandaging. The latter procedure usually accomplishes the control
of the hemorrhage incident to a deep dissection for papilloma or
verucca.
A pad of several thicknesses of sterile gauze is placed upon the wound
and held in place by a few turns of narrow bandage, applied quite
tightly. Though blood may be seen to “spot” through this dressing, it
should occasion no alarm unless the hemorrhage has been clearly either
venous or arterial. Under such circumstances the spurting, either
constant or intermittent, will give immediate evidence of its
character. Active hemorrhage of this nature may yield to tight
bandaging, but ligation of the vessel should be done.
+Venous or Arterial Bleeding+ requiring ligation may be easily dealt
with, and every chiropodist should be equipped with a small artery
clamp with which to grasp the tissues; he should also be provided with
sterile catgut, sizes 0 or 00, with which to ligate a bleeding vessel.
+Antiseptic Precautions.+ In dealing with hemorrhage of even the
slightest degree, it should be remembered that portals of entrance for
bacteria upon the feet require every antiseptic precaution, both as to
the treatment of the wound, and as to the instruments and dressings
which come in contact with it.
For open wounds the U. S. P. tincture of iodin, diluted in water to
one-half strength, is antiseptic and not extremely irritating.
Instruments dipped in pure phenol and dried on sterile gauze are
rendered sterile and may be safely employed.
Dry sterile gauze in the dressing of a clean surgical wound is all
that is necessary. Healing in the absence of infection will be prompt.
The habitual use of ointments and wet dressings should be
discountenanced, except in the presence of a real indication.
CHAPTER VII
+BURNS, FROST BITE, ETC.+
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