TREATMENT OF WOUNDS 101 



I 



' ' The patient once secured, tlie first step is to shave the 

 region: about the wound. A good lihe^ral field is shaved, 

 not merely a narrow strip ailong the* edges. As shaving 

 requires previous washing of the hairs to soften them; 

 the wound itself will become additionally soiled in this 

 process by the lather and hairs falling into it, but as 

 subsequelit treiatment will attend to this, little haita will 

 be done. 'It is, however, not advisable to be unduly care- 

 less in this matter. By shaving first a narrow strij) along 

 the margin, drawing the razor away from the edge, much 

 of this hair-soiling may be avoided. Hair-soiling can 

 also' be prevented soine'what by waidding the cavity with 

 cotton while the sha'ving is being done. 



In a large wound this shaving is no small undertakiiig, 

 but ill no case must it be omitted or slighted on that 

 account. ■ 



The next step is to disinfect the shaved skin. Brisk 

 friction with- mercuric chlorid solution (1 part to 500 of 

 sterile -water) comes first, then it is painted with tincture 

 of iodin, or, what is still better, a solution of iodin crystals 

 in ether. Two drams of iodin to one pound of ether is 

 the solution we are now using for skin disinfection; It 

 seems to assure a better skin disinfection than does the 

 alcoholic -soletion. It penetrates into the recesses of the 

 skin better than the tincture, and thus effects a deeper 

 disinfectionj'i^ 



The surroundings having been thus prepared, atten- 

 tion is now directed to- the^ raw tissues.^ Here we 'find 

 torn muscle' tissue, shreds of fascia, nerves, vessels, sub- 

 cutaneous are61ar tissue, all more or less soiled. Every 

 part of this motley surface is infected and there is no 

 way of disinfecting it with chemicals if the wound must 

 be closed." Strong disinfecting chemical substances that 

 would be capable of killing the microbes now harbored on 

 and within this_ anfractuous surface would also, cauterize. 



