PRACTICAL ANTISEPSIS IN SURGERY. 
801 
In wounds where a large quantity of skin has been destroyed 
disinfect the wound and dust freely with some desiccating anti¬ 
septic powder, frequently enough to secure healing under a dry 
crust or scab. For this purpose Dr. Frick recommends a pow¬ 
der composed of iodoform and pulverized sugar, equal parts. 
In the treatment of open joint, the opening should not be 
allowed to close until the interior of the joint has been rendered 
aseptic. This may be accomplished in ordinary cases, where 
the destructive process has not advanced sufficiently to destroy 
the articular cartilage, by thoroughly washing out the joint 
with proper antiseptics and protecting the external wound with 
a powdered antiseptic, reinforced by a dressing of gauze and 
bandages when practical. 
For this class of cases I prefer a corrosive sublimate solution 
(one to from 1000 to 5000 parts). 
If the wound cannot be thoroughly cleansed through the 
original opening, make one or more other openings that will 
admit of this being accomplished. Other accessory treatment, 
such as internal medication, splints for immobilizing the parts, 
slings, etc., should be used according to the indications of each 
case and the temperament of the patient. 
In treating infected wounds, the first step should be to 
thoroughly wash the parts (wound and surrounding region) 
with soap and water, and cleanse with an antiseptic solution, 
then by means of a knife, scissors, or curette, remove all foreign 
bodies, shreds, necrosed or lacerated tissues, exuberant granula¬ 
tions, etc. 
Then wash the wound with an antiseptic solution until the 
contaminating germs are destroyed. Then treat according to 
the indications of the case ; in other words, render the septic 
wound aseptic and treat accordingly. 
I am of the opinion that we frequently fail in our attempts 
to cleanse infected wounds, because we do not apply active 
germicidal remedies for a sufficient length of time to destroy all 
germ life. But better results will follow the application of a 
solution of medium strength for a longer time, than of a stronger 
