PRINCIPLES OF ANTISEPTIC SURGERY 47 



are essential in dealing with wounds, whether accidental or 

 made by the surgeon : (1) Nothing septic must be left in 

 them ; and (2) Nothing septic must be allowed to get into 

 them. Acting on these principles, wounds which for an 

 hour or two have remained exposed, and into which the 

 ubiquitous dust-particles and organisms have been intro- 

 duced, should first be thoroughly cleansed of mechanical 

 irritants, and then washed, and, if need be, syringed with 

 hydrogen peroxide or a watery solution of corrosive sublim- 

 ate, zinc chloride, or carbolic acid. The wound thus 

 rendered aseptic, and the removal of discharges, if need be, 

 provided for, it is to be protected from access of organisms 

 by antiseptic dressings. Wounds become septic not so 

 much from the germs found in the atmosphere as from those 

 found on the hands of the operator. 



Any wound from a clean knife, or howsoever produced, if 

 it is perfectly aseptic, is as quickly as possible covered with 

 the dressing. This consists of lint, tow, oakum, or other such 

 absorbent substance, saturated with an effectual germicide 

 solution of carbolic acid, which has the advantage of being 

 volatile, of perchloride or biniodide of mercury, or of boric 

 or salicylic acid. These dressings are removed daily, or as 

 required, and are continued till healthy granulations cover 

 and protect the wound. Further, to prevent wounds from 

 being inoculated by septic germs, the knives, probes, 

 ligatures, sponges, drainage tubes, and other appliances 

 used in connection with them, should lie in an antiseptic 

 solution until required, while the operator, whose hands 

 should be most scrupulously clean, must repeatedly moisten 

 his hands with a similar solution. 



Wounds kept strictly aseptic heal quickly ; if otherwise 

 properly treated inflammation rarely appears, inasmuch as 

 the conditions determining irritation are avoided ; pain con- 

 sequently is slight and of brief duration ; suppuration does 

 not occur, its organismal causes being excluded ; blood-clots 

 are preserved from harmful decomposition, and are gradually 

 replaced by new tissue ; portions of damaged structure 

 without hurt are removed ; septicaemia cannot occur when 

 micro-organisms and their products have been destroyed 

 or prevented from entering the protected wound. Serious, 



