TEEATMENT OP WOUNDS 103 



scraping them, at other times trimming them straight 

 with the scissors, may be thought best, depending upon 

 their condition. 



A wound thus mechanically disinfected is a pure 

 wound, as aseptic as a wound of the surgeon's own mak- 

 ing, and it has a large, clean, disinfected field around it. 

 In short, it is a fit wound to close up, and if closed prop- 

 erly it will behave in the manner that will please. 



The wound cavity, having thus been ridden of all 

 microbe-laden tissues, is a safe cavity to bridge over with 

 the skin, but to prevent subsequent contamination provi- 

 sions must be made to prevent accumulation of the serum 

 that will exude from the walls. That is, the cavity must 

 be drained. Serum must not be allowed to remain even 

 momentarily in a wound cavity, for if this microbe food 

 is offered, putrefaction of the serum, followed by infec- 

 tion of the liAdng walls, is sure to follow. The certainty 

 with which microbes creep into favorable places for their 

 growth is now well known to students of aseptic surgery 

 The favorable environment is as certain a source of in- 

 fection as manual soiling. Mutilated, bruised, weakened 

 tissues are prey for microbes, and when these are soaked 

 in a serosity a few otherwise innocuous organisms may 

 soon develop a formidable infection, while strong and 

 only slightly injured tissues would destroy them. In 

 short, when we create a favorable medium and an incu- 

 bator, the microbes are usually there to do mischief, 

 while on the other hand if we create unfavorable soils 

 for microbian growth infections become negligible. 

 These are laws in wound treatment, and they must be 

 obeyed as sacredly as the laws relating to the sterilization 

 of infection carriers, bands, instruments, and so on. 

 Whether these infections of bruised wounds are endoge- 

 nous or exogenous is less important to the practitioner 



