TREATMENT OF WOUNDS 101 



The patient once secured, the first step is to shave the 

 region about the wound. A good liberal field is shaved, 

 not merely a narrow strip along the edges. As shaving 

 requires previous washing of the hairs to soften them, 

 the wound itself will become additionally soiled in this 

 process by the lather and hairs falling into it, but as 

 subsequent treatment will attend to this, little harm will 

 be done. It is, however, not advisable to be unduly care- 

 less in this matter. By shaving first a narrow strip ajong 

 the margin, drawing the razor away from the edge, much 

 of this hair-soiling may be avoided. Hair-soiling can 

 also be prevented somewhat by wadding the cavity with 

 cotton while the shaving is being done. 



In a large wound this shaving is no small undertaking, 

 but in no case must it be omitted or slighted on that 

 account. 



The next step is to disinfect the shaved skin. Brisk 

 friction with mercuric chlorid solution (1 part to 500 of 

 sterile water) comes first, then it is painted with tincture 

 of iodin, or, w^hat is still better, a solution of iodin crystals 

 in ether. Two drams of iodin to one pound of ether is 

 the solution we are now using for skin disinfection. It 

 seems to assure a better skin disinfection than does the 

 alcoholic solution. It penetrates into the recesses of the 

 skin better than the tincture, and thus effects a deeper 

 disinfection. 



The surroundings having been thus prepared, atten- 

 tion is now directed to the raw tissues. Here we find 

 torn muscle tissue, shreds of fascia, nerves, vessels, sub- 

 cutaneous areolar tissue, all more or less soiled. Every 

 part of this motley surface is infected and there is no 

 way of disinfecting it Avith chemicals if the wound must 

 be closed. Strong disinfecting chemical substances that 

 would be capable of killing the microbes now harbored on 

 and within this anfractuous surface would also cauterize 



