PREPARATION OF INSTRUMENTS, ETC. 211 



CHAPTER IX. 



THE PREPARATION OF INSTRUMENTS, LIGATURES, DRESS- 

 INGS, ETC., FOR SURGICAL PURPOSES. 1 



THE purpose of this chapter is to explain the application 

 of the principles set forth on the preceding pages to sur- 

 gical technique. It has been shown that all objects about 

 us may have bacteria on them, and that bacteria are pres- 

 ent on all the surfaces of our bodies that come in contact 

 with the air. All the care that is needed in working with 

 bacteria in the laboratory, and more, must be exercised in 

 surgical operations. Everything that has not been steril- 

 ized must be regarded as having the possibilities of infec- 

 tion in it. After the hands have been cleansed, if they touch 

 the clothing or furniture, they must be cleansed again. 

 If a sterilized instrument falls on the floor, it must be ster- 

 ilized again. The same applies to dressings, sponges, liga- 

 tures, or anything which is to be used about the wound. 



The value of chemical germicides has probably been over- 

 rated in the past. They are used only to destroy the bac- 

 teria on living tissues and on articles that would be damaged 

 by heat. They give less reliable results than boiling. 

 Wherever boiling or steam sterilization is permissible, it 

 should be used. With materials that may contain a small 

 quantity of substance in which bacteria can grow, the frac- 

 tional method of sterilization should be used (see page 63). 

 With glass and metallic objects, obviously a single boiling 

 can accomplish as much as boiling on three consecutive days. 



1 By Marshall Clinton, M.D., Instructor in Clinical Surgery, Medical 

 Department, University of Buffalo. 



