174 Sterilization and Disinfection 



The Disinfection of the Hands, etc. — The disinfection of the 

 skin — both the hands of the surgeon and the part about to be incised 

 — is a matter of the utmost importance. Washing the hands with 

 soap, which has marked germicidal properties, will in many cases 

 suffice to destroy or remove bacteria from smooth skins. This 

 method, which is regarded by some surgeons as adequate, is not, 

 however, commonly regarded as suflB.cient protection to the patient 

 who might be infected by any remaining micro-organisms. To 

 overcome this, many surgeons prefer the use of sterilized gloves 



a b c d 



Fig. 41. — Different types of bacteriologic filters: a, Kitasato; b, Berkefeld; c, 

 Chamberland; d, Reichel. 



of thin rubber to all other means of preventing manual infections. 

 Others prefer to use detergent and disinfectant measures. The 

 method at present generally employed, and recommended by 

 Welch and Hunter Robb, is as follows: 



The nails must be trimmed short and perfectly cleansed. The hands are 

 washed thoroughly for ten minutes in water of as high a temperature as can 

 comfortably be borne, soap and a previously sterilized brush being freely used, 

 and afterward the excess of soap washed off in clean hot water. The hands are 

 then immersed for from one to two minutes in a warm saturated solution of 

 permanganate of potassium, then in a warm saturated solution of oxalic acid,, 

 until complete decolorization of the permanganate occurs, after which they are 

 washed free from the acid in clean warm water or salt solution. Finally, they 

 are soaked for two minutes in a i : 500 solution of bichlorid of mercury. 



Lockwood,* of St. Bartholomew's Hospital, recommends, after the use of the 

 scissors and penknife, scrubbing the hands and arms for three minutes in hot 

 water and soap to remove all grease and dirt. The scrubbing brush ought to be 

 steamed or boiled before use, and kept in i : 1000 biniodid of mercury solution. 

 When the soapsuds have been thoroughly washed away with plenty of clean 

 water, the hands and arms are thoroughly washed and soaked for not less than 



* "Brit. Med. Jour.," July 11, 1896. 



