SURGICAL ANTISEPSIS AND ASEPSIS 513 



occurred, or is unavoidable. The gross neglect of aseptic precautions, 

 often seen in the operations of veterinary surgery, would be considered 

 criminal practice in human surgery. 



Asepsis is, nevertheless, very difficult to secure in the lower animals 

 living among filthy surroundings and lying on fecal discharges. In addi- 

 tion to these disadvantages the trouble of controlling animal movements 

 during operation, and of keeping dressings in place, make the attainment 

 of asepsis embarrassing and frequently impossible. The more common 

 administration of anesthetics would facilitate asepsis by preventing move- 

 ments of the patient and contact of the operative field with dirt. 



But there are all degrees of infection, and while, with the best 

 methods of securing cleanliness at our command, it is impossible to com- 

 pretely sterilize normal skin and tissues, yet the surgical result may be 

 perfect. Therefore, in surgical operations, we should endeavor to pro- 

 cure as small an amount of infection, or dosage of micro-organisms, as 

 possible, consistent with existing environment and conditions. 



The following aseptic technic is especially applicable in the case 

 of any surgical operation undertaken upon a noninfected part. If it is 

 possible to carry out all the details, and the result is successful, healing 

 will take place without suppuration. 



To prepare the surface of the body for operations, the hair is first 

 clipped and shaved, the skin is thoroughly scrubbed with a brush, green 

 soap and water for ten minutes, and then with 70 per cent, alcohol. 

 Since tincture of iodine has come into vogue the preceding method has 

 been superseded by iodine with many operators. In this case the hair 

 should be shaved the day before when water and soap may be used. 

 Before the operation the dry skin is cleansed with gasoline, or when 

 this is undesirable on account of its inflammability, ether may be used. 

 Then tincture of iodine is painted all over the operative field and 

 allowed to dry before the operation is begun. On delicate parts the 

 tincture should be diluted with an equal amount of alcohol. After the 

 skin is incised there is no further necessity for antiseptics unless the 

 wound is already infected, or becomes so by exposure to impure air or 

 contact with dirt. The hands of the operator, including the finger nails, 

 should be brushed until clean with green soap and water, and then with 

 70 per cent, alcohol. 



In accidental wounds the tincture of iodine or dichloramine-T is the 

 most efficient agent. 



As we have seen the skin must not be wetted with water in order 

 that the iodine penetrate into its "pores." Washing also carries germs 

 into the wound. The hair should be cut from the dry skin with scissors 

 or by shaving the dry skin with a razor. The skin is cleansed by mop- 

 ping with gasoline or ether and the dirt removed from the wound by 

 forceps and scissors and gauze. 



Then a large surrounding area of skin and the wound itself should 

 be swabbed with pure tincture of iodine by means of a brush, or absorb- 

 ent cotton on a stick. After suturing the wound it is best to swab over 

 the line of sutures with tincture of iodine and allow it to dry before 

 dressing. In burns and all accidental wounds and emergency cases the 



Digitized by Microsoft® 



