88 WOUND TREATMENT 



Wound Packing", Drainage Wicks, and Draining- Tubes 



Inasmuch as we continue to use compression packs to 

 control copious bleeding after some of our operations, 

 these are capable of acting as carriers of bad infections. 

 A soiled wound-pack sewed up tightly in a traumatic cav- 

 ity is a mighty dangerous object. In twenty-four hours 

 it is fetid, and in forty-eight hours, if not removed or the 

 sutures loosened to admit air, malignant edema is very 

 likely to have developed. The large cavities of ridgling 

 castration, of fistulse of the withers, of poll evils, and of 

 large tumors are to be feared in this connection. Re- 

 cently a case of this kind came to my notice. A ridgling 

 castrated after some difficulty was packed with cotton 

 that was simply disinfected in mercuric chlorid solution 

 made from well water and contained in a milk pail. The 

 wadding was held in place by snapping the edges of the 

 wound with a clamp forceps. When removed forty-eight 

 hours later the wadding was fetid, the scrotum was swol- 

 len, and the patient stiff and sick. There was a per- 

 ceptible emphysema in the loose areolar tissue along the 

 inguinal canal. Two days later the patient was swollen 

 with an emphysematous edema along the ventral surface 

 of the body as far forward as the elbows. Death oc- 

 curred a few hours later. I have had similar results from 

 operations upon fistula of the withers where soiled pack- 

 ings were injudiciously allowed to remain sewed up too 

 long. These infections are wound-packing infections, and 

 must be reckoned with in w^ound treatment. 



The best wound packing is sterilized oakum, sterilized 

 by boiling and not alone with antiseptics. Oakum is bet- 

 ter than cotton for this purpose because the latter stub- 

 bornly mats into raw tissues and stays there for two or 

 three days. An oakum pack comes out en masse, leaving 

 no particles behind. 



