WOUND HEALING 129 



less than it would have been had he permitted the wound 

 to remain infected and thus require daily treatments. 



Aseptic Surgery and Wound Dressing 



Large lacerated wounds are properly prepared by first 

 shaving the hair from all adjacent tissues, then thor- 

 oughly cleansing the wound and marginal tissues and 

 removing all fragments of tissue, after which the wound 

 margins are brought in apposition and maintained in a 

 fixed immobile position. The method of procedure that 

 should be resorted to in cleansing a wound prior to 

 bringing the various parts of it in apposition with sutures 

 or otherwise, should be determined by the nature of the 

 wound. In a lacerated wound in which there has been 

 introduced filth, such as dirt, fecal matter, and hair, the 

 parts should be thoroughly washed with physiologic salt 

 solution until the filth has been entirely removed. The 

 tissue shreds should then be removed by the use of 

 sterile instruments, and some disinfectant used in further 

 cleansing the part. The application of the disinfectant 

 should be again followed by washing with sterile physio- 

 logic salt solution, for be it remembered that if disin- 

 fectants are applied tissues are destroyed, the extent 

 of which will depend upon the strength of the disin- 

 fectant and the duration of its application ; the purpose 

 of the application of the disinfectant is to insure the 

 destruction of all infectious agents, and the object of 

 the application of the salt solution after the disinfectant 

 is to wash away all excess disinfectant. 



Such treatment of a wound will necessarily require 

 considerable time. I have seen some such wound treat- 

 ment, and in one instance I remember where the irriga- 

 tion with the salt solution was continued for four to five 

 successive hours. In this wound some thirty sutures were 



