XVIl] 



BACTERIOLOGY, ANTISEPTICS AND DISEASE 



205 



The Aseptic Treatment of Wounds 

 and Aseptic Surgery 



802. From the foregoing remarks on the 

 cause and prevention of disease it will be clear 

 to the most unscientific mind that successful 

 surgery is impossible, except by occasional good 

 luck, unless aseptic methods are resorted to. 



When Lord Lister first suggested the idea of 

 using certain drugs to fight germs in surgical 

 operations he was ridiculed, and, in fact, it 

 was not until he had shown to many eminent 

 medical men that operations which had pre- 

 viously been impossible could be performed if 

 the use of these drugs were resorted to that any 

 attention was paid to his teaching. However, 

 directly this fact became widely known, surgery 

 was revolutionised. In short, Lister showed to 

 the world that by the use of solutions such as 

 carbolic, coal tars, etc., surgery could be prac- 

 tised without any risk of death from blood 

 poisoning. 



At this time the exact reasons were unknown, 

 although it had been suggested for over two 

 centuries that disease-producing organisms did 

 exist. Later, however, Louis Pasteur, who has 

 been rightly called the true founder of bacteri- 

 ology, brought before the world the results of 

 his wonderful bacteriological researches. Lord 

 Lister himself, in 1892, acknowledged to Pasteur, 

 "Truly there does not exist in the entire world 

 any individual to whom the medical sciences 

 owe more than they do to you. Thanks to you, 

 surgery has undergone a complete revolution, 

 which has deprived it of its terrors and has 

 extended almost without limit its efficacious 

 power" (Jordan's "Bacteriology"). 



There is room for a great deal of improve- 

 ment in this direction in the manner in which 

 many operations are performed upon animals. 

 Great risks-are run daily, yet if an owner loses 

 a valuable horse he is assured by the operator 

 that it could not have been helped ; whilst in 

 reality the horse would probably not have died 

 if aseptic surgery had been resorted to. It is a 

 case of " where ignorance is bliss." 



Modern schools, however, are teaching the 

 latest methods of aseptic surgery, and we look 

 forward to the time when the old-school methods 

 will become obsolete. 



803. Wounds. There are four types of 

 wounds : cut, tear, puncture, and bruise. 



Cut wounds are those which have a clean, 

 sharp edge, the blood-vessels being cut straight, 

 and not jagged ; these wounds heal very quickly 

 if the two surfaces are brought near together. 

 The old idea, however, that two clean-cut 

 surfaces, when brought together, would unite 

 spontaneously is incorrect. 



Torn wounds, which are made by hooks and 

 blunt instruments, do not heal so quickly, 

 although they generally bleed less. The exposed 



surfaces are stretched, and portions of them have 

 to be removed or fall off before the wound heals. 



Punctured wounds are generally deep and 

 small, and are therefore dangerous because infec- 

 tion enters deeply into the system. A nail prick 

 from careless shoeing is the most common form 

 of punctured wounds. 



Bruised wounds are the commonest and most 

 serious that we meet with in horses. They are 

 difficult to heal. Such examples are bruises from 

 falls, broken knees, harness and saddle galls, 

 treads, quittor, brushing, over-reach, etc. In a 

 bruise the skin may or may not be broken ; but 

 it must be remembered that germs can enter 

 through bruised tissue, although not as easily as 

 through an open wound. 



804. Method of Healing. Wounds heal by 

 each surface throwing out material, called 

 granulations, which gradually fill up the wound ; 

 this material is not the same as flesh, but is a 

 temporary substitute. On the top of this a sitfast 

 (scab) forms. After the wound has healed up 

 the granulated material gradually shrinks up, 

 drawing the original edges of the wound 

 together, and the sitfast comes off. Eventually 

 tl e granulations are entirely absorbed (in most 

 cases), and the flesh becomes as it was before 

 the wound was made. As a rule, however, a 

 permanent mark is left on the skin, and the coat 

 of a horse does not grow normally over the place 

 where the wound was. White hairs usually 

 grow on these places. The benefit of the sitfast 

 is that it acts as a preventive against the ad- 

 mission of germs ; hence it is wrong to pick it 

 off, and specially to do this with unclean fingers, 

 as is so commonly done. 



Aseptic Treatment of Wounds 



805. In treating wounds it must be clearly 

 understood that all we have to do is to assist 

 Nature to heal. We have to remove all foreign 

 substances present and prevent the admission of 

 further foreign substances which would hinder 

 Nature's work. The treatment of wounds is 

 quite simple if this principle is understood. As 

 long as live microbes are present in the tissues 

 of a wound it will not heal. 



First, we must arrest the bleeding, which is 

 done by styptics, pressure, cold applications, 

 cautery, ligature, or by actually closing the 

 artery or vein with artery forceps. Bleeding will 

 not stop of its own accord unless the blood is per- 

 mitted to clot ; the chemical changes that go on 

 before the blood clots are very complicated. 

 Broadly speaking, the fluid portion of the blood 

 (plasma) consists of serum and fibrinogen. When 

 tissue is exposed to the atmosphere, very com- 

 plex chemicals are produced which, when they 

 come in contact with this fibrinogen in the blood, 

 produce fibrin, which is clot. This production 

 of clot takes about two minutes. If it took 



