If the wound is small, and there is no discharge from it, it may be
painted with collodion or covered with boric-acid ointment (sixty
grains of boric acid to the ounce of vaseline) after the first day. If
large, it should be covered with cotton gauze or cloth which have been
boiled or specially prepared for surgical purposes. If pus ("matter")
forms, the wound must be cleansed daily of discharge (more than once
if it is copious) with boiled water, or best with hydrogen dioxide
solution followed by a washing with a solution of carbolic acid (one
teaspoonful to the pint of hot water), or with a solution of mercury
bichloride, dissolving one of the larger bichloride tablets, sold for
surgical uses, in a quart of water.
It is a surgical maxim never to be neglected that wounds should not be
allowed to close at the top before healing is completed at the bottom.
As to close at the surface is the usual tendency in wounds that heal
slowly and discharge pus, it is necessary at times to enlarge the
external opening by cutting or stretching with the blades of a pair of
scissors, or, and this is much more rational and comfortable for the
patient, by daily packing the outlet of the wound with gauze to keep
it open.
=BLEEDING FROM SCALP.=
_First Aid Rule 1.--Cut hair off about wound, and clean thoroughly
with carbolic-acid solution (one teaspoonful to pint of hot water)._
_Rule 2.--Put pad of gauze or muslin directly over wet wound, and make
pressure firmly with bandage._
In case of wounds of the scalp, or other hairy parts, the hair should
be cut, or better shaved, over an area very much larger than the
wounded surface, after which the cleansing should be done. To stop
bleeding of the scalp, water is applied as hot as can be borne, and
then a wad of boiled cotton should be placed in the wound and
bandaged down tightly into it for a time. Closing the wound with
stitches will stop the bleeding much more effectively, however, and is
not very painful if done immediately after the accident. The stitches
should be tied loosely, and not introduced nearer to each other than
half an inch, to allow drainage of discharge from the wound.
=General Remarks.=--All wounds should be kept at rest after they are
dressed. This is accomplished in the case of the lower limbs by
keeping the patient in bed with the leg raised on a pillow.
The same kind of treatment applies in severe injuries of the hands. In
less serious cases a sling may be employed, and the patient may walk
about. When the injury is near a joint, as of the fingers, knee,
wrist, or elbow, a splint made of thin board or tin (and covered with
cotton wadding and bandaged) should be applied by means of surgeon's
adhesive plaster and bandage after the wound has been dressed. In
injuries of the hand the splint should be applied to the palm side,
and reach from the finger tips to above the wrist. Use a splint also.
=NOSEBLEED.=
_First Aid Rule 1.--Seat patient erect and apply ice to nape of neck._
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