388  Treatment  of  Contusions  and  Wounds.  {^iiJust.S™' 
had  best  be  used.  Solution  carbolic  acid  (carbolic  acid  fgj,  glycerin 
fgj,  mix  thoroughly  and  add  water  t.^xxxviij),  corrosive  sublimate 
or  iodoform  gauze,  oil-silk,  iodol,  iodoform  or  thymol  iodide,  absor- 
bent cotton,  bandages  for  fingers  y±  inches  x  I  yard,  for  extremities 
2  to  3  inches  x  8  yards,  for  the  body  4  inches  x  12  yards,  for  the 
head  2  to  2'j£  inches  x  6  yards,  sponges  (absorbent  cotton  can  otten 
be  used  in  place  of  the  latter  in  minor  surgery),  scissors  (one  pair 
curved  on  the  flat  for  cutting  hair  from  the  scalp),  needles  (those 
curved  on  the  point  being  the  most  useful),  forceps  for  inserting  the 
needles,  silk  for  sutures,  a  clean  towel  (not  the  ordinary  drug-store 
towel),  fountain  syringe,  and  basins  (porcelain  lined). 
METHOD  OF  PROCEDURE  IN  TREATING  WOUNDS. 
(1)  Wash  hands  thoroughly  and  dry  them  on  a  perfectly  clean 
towel,  (2)  prepare  antiseptic  solutions,  (3)  put  instruments,  oil-silk 
and  needles  threaded  in  carbolic  solution,  (4)  cleanse  wound  thor- 
oughly by  solution  corrosive  sublimate  and  fountain  syringe,  (5)  in 
case  of  scalp  wounds  first  remove  the  hair,  (6)  if  wound  gaps, 
approximate  the  edges  by  oxide  of  zinc  plaster  or  by  suturing.  In  put- 
ting in  a  suture,  grasp  the  needle  firmly,  introduce  it  into  the  flesh, 
taking  a  good  hold,  and  bring  it  out  the  other  side.  Sutures  may 
be  of  the  interrupted  or  the  continuous  type.  After  the  several 
threads  are  introduced,  the  edges  of  the  wound  are  pulled  together 
and  each  thread  is  tied  in  a  reef  or  surgeon's  knot,  the  knots  being 
pulled  to  one  side  over  the  sound  flesh,  then  one  end  is  cut  and  one 
left  long,  to  be  used  in  pulling  out  the  stitches  after  the  wound  has 
healed. 
After  the  wound  has  been  sewed,  it  should  again  be  cleansed  by 
the  antiseptic  solution,  then  the  oil-silk  (previously  rendered  aseptic) 
should  be  applied,  then  the  medicated  gauze,  absorbent  cotton  and 
bandages,  the  part  thus  being  placed  at  rest.  The  oil-silk  is  applied 
directly  to  the  wound,  so  that  the  new  tissue  which  is  formed  will 
not  become  adherent  to  the  dressing  and  be  torn  up  when  the  dress- 
ing is  removed. 
The  treatment  of  a  lacerated  wound  is  about  the  same,  with  the 
exception  that  there  is  usually  considerable  destruction  of  tissue, 
which  must  be  trimmed  away;  on  account  of  the  dirt  which  is  apt 
to  be  ground  into  such  a  wound  it  should  be  very  carefully  cleansed. 
Before  applying  the  dressing  to  the  wound,  it  should  be  dusted  with 
