176 



Sterilization and Disinfection 



germicidal substance, with two results^viz., that a great number of 

 feeble germicides have been discovered, and that belief in the efficacy 

 of all germicides has been somewhat shaken; hence the aseptic surg- 

 ery of the present day, which strives to prevent the entrance of germs 

 into the wound rather than to destroy them afterwards. 



For a complete discussion of the subject of antiseptics in relation 

 to surgery the reader must be referred to text-books of surgery. 



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 



Fig. 34. — Different types of bacteriologic filters: a, Kitasato; 6, Berkefeld; c, 

 Chamberland; d, Reichel. 



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

 however, commonly regarded as sufficient protection to the patient 

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

 overcome this, many surgeons prefer the use of sterilized gloves 

 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, 



