REPAIR OF WOUNDS 133 



clot, and kept aseptic — that is, left alone. A clean clot 

 is an excellent culture medium for embryonic epithelial 

 cells. As healing progresses, a portion of the unab- 

 sorbed clot is pushed out by the granulating tissue and 

 dries in a scab which protects the surface of the wound. 

 Aseptic clot repair occurs typically in simple fractures, 

 subcutaneous tenotomes, internal rupture of organs, and 

 healing of bone cavities following the radical operation 

 on sequestra. It is nature's peerless method, and one 

 that we should endeavor to imitate whenever the con- 

 ditions permit. No other packing is as good as clean 

 blood clot. No other wash is as good as blood serum. 



Given a recent wound of accidental nature, how shall 

 we render it aseptic? In ordinary cases one thorough 

 cauterization with iodin is usually sufficient, all subse- 

 quent dressings to be without antiseptics of any kind. 

 In wounds which give rise to the fear of tetanus or 

 rabies, however, pure phenol is preferable. If the wound 

 has a cavity, the phenol should be poured in after moist- 

 ening the surrounding skin with alcohol, and allowed to 

 remain one minute. It may then be removed with a 

 dropper, and alcohol applied. If it is a puncture wound, 

 the phenol must be applied on a cotton-wrapped probe, 

 opening the track of the puncture if necessary to permit 

 access to the farthest point. If it be a freely-bleeding 

 wound, and still bleeding, I believe cauterizing is un- 

 necessary under any conditions. 



Many authorities are now reporting happy results from 

 leaving granulating wounds and ulcers freely exposed 

 to the air, under a wire netting for protection against 

 insects or injury. Some writers report excellent results 

 from treating skin grafts in this manner. 



Brewer's yeast is a remedy I have found very useful 

 for hastening the separation of old sloughs and stimu- 

 lating granulations. It smarts a trifle, but patients do 



