The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
=Treatment.=--As soon as suppuration threatens speedy measures should
be adopted, either for the purpose of bringing about resorption, or of
favoring and hastening suppuration. In theory antiseptic applications
are demanded; in practice they are sometimes of benefit. These may
consist of mere soothing applications, as a lead and opium wash, or
some other wet or dry astringent applied upon the surface; or they
may consist of cold applications, which by their astringent action
will limit the amount of exudate and prevent its further infection.
Or advantage may be taken of the properties of moist heat, and the
application of hot poultices or fomentations may encourage exudation,
but particularly quicken superficial breaking down, and thus hasten
the time when the phlegmon shall point, or come sufficiently close
to the surface to show that its contents are pus and permit of
evacuation. Such local applications, therefore, give relief from pain
and hasten favorably the suppurative process. In cases of phlegmonous
infiltration, the application of an ointment composed of resorcin 5,
ichthyol 10, mercurial ointment 35, and lanolin 50 parts, or else the
Credé silver ointment, is beneficial. Under the influence of these
antiseptic and sorbefacient preparations, and of moist heat, many
phlegmonous infiltrations assume a kindlier type, and may secure the
actual resorption of pus.
Finally in almost every case pus must be evacuated. Here the universal
rule may be applied, to which there are practically no exceptions,
and which should be stamped on the mind of every student and young
practitioner. It is--that _pus left to itself will do more harm than
will the knife of the surgeon if judiciously used for its evacuation_.
Action taken in accordance with this rule may be considered wise and
timely. The operation of evacuation may at one time be a mere puncture,
or possibly the aspirating needle alone will be enough; at other
times it requires extensive and careful dissection and entails no
little responsibility. This is particularly true in such deep-seated
suppurations as those around the appendix and in the brain, while in
the deep-seated bone lesions of this character the use of the bone
chisel or the cutting forceps may be of use. But the rule holds good,
no matter where the pus may be, and as long as good judgment is shown
in the operative procedure nothing but good can come from recognition
of this law. After the evacuation of pus the cavity should be cleansed
and disinfected with hydrogen dioxide, perhaps even with caustic
pyrozone, or, if these are not at hand, with other suitable antiseptic
solutions.
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