TECHNIC OF ANTISEPSY AND ASEPSY. 65 
tion by first intention ; in fact, it may be entirely absorbed. Such is 
the case also of ligatures left in the wounds; they are digested by 
the tissues, destroyed in a few days: by the migratory cells and by 
newly formed elements (catgut), or are encysted and slowly ab- 
sorbed (silk). 
If immediate reunion be looked for, every care necessary to prevent 
the wound from being contaminated should be resorted to. Perfect 
hemostasis and an exact closing of the wound are two essential 
conditions. A thin bloody aseptic layer, interposed between the 
edges, does not prevent primitive union ; tissues support it and in fact 
utilize it for the process of repair ; but large clots are absorbed with 
difficulty and form a ground most favorable to the multiplication of 
pyogenic microbes. Raw surfaces, dried as completely as possible, 
and covered with antiseptic vaseline (vaseline 50, pulverized boric 
acid 5, iodoform 1), are to be brought close together throughout 
their whole extent, in their superficial and their deep part; the 
contact must be uniform and entire. When the contact does not 
exist in the depth of the wound, a dead space is left, where the 
blood and the serosity gather, an ‘‘antiplastic’” center, where the 
germs which may remain in it will rapidly multiply. In cases. 
where the wound involves several layers of tissues, it is necessary, 
in order to keep them close together, to add to the silk or silk-worm 
gut stitches on the surface, some catgut or silk sutures lower down, 
held at their extremities by small rolls of gauze (quilled suture). 
Washing the suture with corrosive sublimate, drying it with wadding, 
and covering it with iodoform collodion or a cotton dressing, com- 
pletes the operation. 
In wounds, where the perfect adaptation of the edges is not pos- 
sible, or in traumatism with loss of substance, one must provide for 
the escape of the secretions of the wound by drainage obtained 
either with one or with several rubber tubes (tubular drainage), or 
with disinfected horse hair or silk-worm gut (capillary drainage), or 
again with gauze (draining tent). Rubber drain tubes are mostly 
used. They are secured to the lips of the wounds with thread, silk, 
or hair. They allow antiseptic injection without interfering with 
the sutures. 
Such are the measures required by asepsis and antisepsis, in order 
to give subjects operated upon, as nearly as can be, absolute protec- 
tion against infection. And many are the superfluous details which 
we have omitted. 
In most hospitals for human patients, a perfect appliance of special 
apparatus for disinfection, and of numberless precautions, insure, 
for a certainty, the success of the operation ; the surgeon can always 
obtain, when he wants it, reunion by first intention, and render 
harmless the long manipulations he has to make in the abdominal 
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