Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
Nourishment for the first three days should be liquid, on account of
the intense congestion of the alimentary tract Food is gradually
increased according to conditions. There should be the usual care of
the bowels, skin and kidneys, but in our zeal over the local
treatment, we should not forget that we have to care for a patient
whose blood is loaded with toxins, and whose lungs, stomach, kidneys,
and other organs are congested and filled with emboli. At first, dress
the burns daily, gently wiping away the discharge of serum and broken
down cells, which is poisonous and irritating, with dry gauze or
cotton. Blisters are opened and pieces of loose skin removed with
sterile scissors or forceps, but all skin is left in place as long as
possible to protect the underlying, new forming skin. Every dressing
should be made with a septic care: clean hands, clean gauze and clean
instruments. As soon as the slough begins to form, if there is much
odor, it is well to apply a continuous wet dressing (see later
reference). In case of a burn caused by carbolic acid, the skin is
neutralized by the use of absolute alcohol (95 per cent.). In burns
from trichloracetic acid, use alkaline remedies as sat. sol. of sodium
bicarbonate. Burns from caustic alkalies are neutralized by vinegar or
by some other mild acid such as boric acid. A so-called X-ray burn is
not a burn at all; the observable results of such an accident are not
manifested until several days or even several weeks after the
application of the rays, at which period an inflammatory or a
gangrenous process arises, which begins within the deeper tissues and
subsequently involves the surface. These burns are often accompanied
by loss of hair or of nails in the damaged area; they frequently
remain unhealed for months; if they heal at all, they are very
painful, and are not improved by the treatment which relieves
ordinary burns. In some cases the consequences are very serious.
Ambrine is a newly proposed remedy.
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