TEEATMENT OF WOUNDS -91 



generally succeed in keeping our really aseptic wounds 

 from harm. 



The postoperative conveyors are the patient's' bed and 

 stall and the attendant's hands, syringes, solutions, pow- 

 ders, and dressings. 



The patient's habitat is made safe, by keeping the 

 wound covered, keeping the patient in the standing posi- 

 tion, and keeping up a sensible state of cleanliness in 

 the surroundings. 



The handling of wounds by attendants should be 

 avoided. They might be entrusted with the dusting of 

 powder on a sutured wound, applying a clean piece of 

 gauze or cotton and wrapping a bandage over all, but 

 this is as far as any untrained hands should be trusted 

 in the treatment of aseptic wounds. A wound requiring 

 irrigation and renewal of drainage wicks or tubes re- 

 quires also the intelligent assistant or surgeon, as these 

 means are sure to infect. 



Syringes and solutions in wound treatment should be 

 given into the hands of others only in the treatment of 

 suppurating cavities where refinement is unnecessary. 



I would summarize the plans of handling the various 

 conveyors of infection as follows : 



1. Operate in an atmospliere that is free from dust, and prevent 



objects from being whirled about by the patient. Avoid 

 loose bedding, and moisten the patient to keep the hair 

 from flying. ' 



2. Boil instruments for fifteen minutes and so handle them dur- 



ing the operation as to prevent contamination. Call for 

 other instruments to replace those soiled. 



3. Avoid touching the wound with the fingers. Use tissue for- 



ceps, tumor forceps, and needle holders. It is seldom neces- 

 sary to touch wounds with the fingers.' When digital work 

 is necessary, wash the hands, rinse them in mercuric ehlorid 

 (1 to 500), and coat the finger tips with tincture of iodin. 



4 Use only sterilized water and sterilized basins. 



5. Prepare a large surgical field in the manner above recom- 

 mended. » • J- 



6 Use sterilized sutures and bathe them in tincture ofdodin. 

 Keep them from trailing over the dirty body. Handle them 



