The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatusHill, Berkeley
Science
The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatus
Hill, Berkeley
Bandages and bandaging; Dislocations -- Treatment; Fractures -- Treatment; Surgery, Minor
_To Dress recent Wounds._—When the apparatus is ready, the piece of
tin is cut and fitted to the wound, so that it shall overlap the
wound to a small extent on all sides; then a piece of lac plaster,
large enough to overlap the tin one or two inches all round; this
plaster may be cut and notched when the surface is irregular to make
it lie pretty closely; then strips of diachylon, about two inches
broad, are cut ready. The parts around the wound are well cleaned;
dirt and clots cleared from the wound with cold water, containing
about 1 of carbolic acid to 40 of water, and the interior of the
wound is freely syringed with water containing 1 of acid in 30 or
even 1 in 20 parts. The sides are brought together with sutures,
if necessary, in the ordinary way, and the tin laid on the wound;
the tin is freely wetted with carbolic water, and the lac plaster
laid over it and kept _in situ_ by strips of diachylon plaster. In
dressing recent wounds the most dependent side of the lac plaster is
left unattached, that the serous discharge, which is often copious,
may readily escape. To receive this discharge, a piece of calico,
soaked in carbolic oil, is laid over the wound now covered in,
and all kept in place by a folded towel or a roller bandage. This
oily cloth is to be changed from time to time as it gets soaked
with discharge: at first this change is necessary every night and
morning, but after three or four days once a day is often enough. The
shell-lac plaster and tin need not be removed for a week unless the
wound grow hot and painful, when they can be removed at any time if
the surface of the wound is immediately smeared with carbolic oil,
and kept well imbued with the antiseptic while it is being examined.
Should it contain pent-up discharge, the sutures must be loosened and
the discharge washed out by injecting the 1 in 30 aqueous solution.
The tin and lac plaster may be then replaced, and the dressing
renewed. The same precaution must be followed when the sutures have
to be removed. Usually there is very little swelling and no pain,
and the healing process goes on tranquilly if undisturbed. Should
bruised parts slough, they may be trimmed away with scissors dipped
in carbolic oil. When the wound has once been washed with carbolic
acid, the antiseptic should not enter the wound a second time, as its
irritant qualities excite inflammation in the wound.
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