2IO MANUAL OF BACTERIOLOGY. 



CHAPTER IX. 



THE PREPARATION OF INSTRUMENTS, LIGATURES, 

 DRESSINGS, ETC., FOR SURGICAL PURPOSES.* 



The purpose of this chapter is to explain the application 

 of the principles set forth on the preceding pages to surgical 

 technique. It has been shown that all objects about us may 

 have bacteria on them, and that bacteria are present on all 

 the surfaces of our bodies that come in contact with the air. 

 All the care that is needed in working with bacteria in the 

 laboratory, and more, must be exercised in surgical opera- 

 tions. Everything that has not been sterilized must be re- 

 garded as having the possibilities of infection in it. After 

 the hands have been cleansed, if they touch the clothing or 

 furniture, they must be cleansed again. If a sterilized instru- 

 ment falls on the floor, it must be sterilized again. The same 

 appHes to dressings, sponges, hgatures or anything which is 

 to be used about the wound. 



The value of chemical germicides has probably been over- 

 rated in the past. They are used only to destroy the bac- 

 teria on living tissues and on articles that would be damaged 

 by heat. They give less reliable results than boiling. Wher- 

 ever boiling or steam sterihzation is permissible, it should be 

 used. With materials that may contain a small quantity of 

 substance in which bacteria can grow, the fractional method 

 of sterihzation should be used (see page 51). With glass and 

 metalUc objects, obviously a single boihng can accomplish as 

 much as boiling on three consecutive days. 



* By Marshall Clinton, M.D., Instructor in Clinical Surgery, Medical De- 

 partment, University of Buffalo. 



