Am.  Jour.  Pharm.) 
January,  1897.  J 
Modern  Surgical  Dressings. 
33 
to  a  vacuum  of  10  or  12  pounds;  saturated  streaming  steam  is  then 
let  in ;  the  temperature  soon  rises  to  possibly  2400  F.,  and  the  press- 
ure gauge  indicates  5  or  10  pounds.  The  steam  pipes  are  now 
closed ;  the  vacuum  pump  is  again  started  until  the  proper  vacuum 
is  obtained. 
Again  steam  is  turned  on,  and  so  on,  in  turn,  currents  of  satur- 
ated steam  follow  each  other  through  the  vacuum  for  from  one  to 
two  hours.  Every  part  of  the  chamber  is  penetrated,  every  fibre  is 
subjected  to  the  action  of  this  highest  of  bactericides.  The  most 
resistant  form  of  germ  life  must  be  reached  and  destroyed.  From 
the  sterilizing  chamber  the  gauze  passes  directly  into  the  aseptic 
room.  In  this  room,  all  persons,  tables  and  apparatus  having  been 
previously  prepared,  the  dressings  are  cut,  folded  and  packed  in  the 
jars,  the  covers  laid  on  loosely. 
(A  large  portion  of  this  work  is  done  by  apparatus,  to  avoid 
touching  with  the  hands.) 
This  work  is  rapidly  performed,  and  the  filled  jars  returned  to 
the  sterilizing  chambers  for  a  re-sterilization.  This  'final  steriliza- 
tion effectually  secures  absolute  safety  against  the  remote  possibility 
of  infection  by  handling.  After  this  final  sterilization  the  jar  seals 
are  locked.  For  dressings  packed  in  jars,  this  process  is  one  of 
hermetic  sealing,  a  partial  vacuum  having  been  formed  within  the 
jars  during  their  heating  and  cooling.  The  finished  dressings  now 
pass  on  to  be  labelled,  put  in  cartoons  and  made  ready  for  shipment. 
These  same  chambers  are  utilized  for  disinfection  with  formalde- 
hyde vapors,  the  process  being :  first  heating  of  the  chambers,  ex- 
haustion of  the  air,  filling  the  chamber  with  formaldehyde  vapors, 
which  penetrate  every  portion  of  the  material ;  finally,  exhaustion  of 
the  formaldehyde  vapors,  which  are  in  turn  replaced  with  heated  air. 
Sterilization  Tests. — The  effectiveness  of  sterilization  procedures 
can  be  readily  confirmed. 
In  the  writer's  laboratory  the  practice  is  substantially  as  follows  : 
A  portion  of  the  dressing  material  (for  example,  a  piece  of  gauze) 
is  impregnated  with  an  infected  nutrient  fluid.  The  thus  infected 
material  is  then  dried  in  air,  that  the  organisms  may,  as  far  as  pos- 
sible, be  placed  in  a  resistant  condition.  As  a  check  experiment,  a 
portion  of  this  infected  and  dried  material  is  placed  in  sterilized 
nutrient  jelly  in  the  culture  chamber.  This  is  done  to  ascertain 
whether  the  test  material  has  surely  been  infected.    The  remaining 
