Sealing of operative wounds about the abdomen v. treatment by dressing / by E. Stanmore Bishop.

  • E. Stanmore Bishop
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Sealing of operative wounds about the abdomen v. treatment by dressing / by E. Stanmore Bishop. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    early antiseptist, and of many other surgical tools and appli- ances. But its full effect can not even now he said to be fully appreciated. In two things especially, change is still going on, and opinion is not yet fully settled. It has always been noticed that after division of any tissues, and especially after the separation of those previously adherent through inflamatory changes, that although all spouting or even evident vessels were closed by ligature, twisting, sponge pressure, or in any other way, fluid still continued to exude from the raw surfaces : such fluid was usually coloured to some extent by blood, and when bacteriology was even faintly understood, was recognised as excellent culture material for the growth of micrococci.* Any failure to avoid septic processes in the wound, or in the cavity where these raw surfaces existed was attributed to the presence of this fluid, which gradually accu- mulating, and becoming stagnant in the closed wound or cavity, was supposed to decompose, and it was assumed that the accompanying or sequent septicaemia was due to the absorption of poisonous material thereby resulting. And no one can doubt but that this was true. The practice adopted was however one-sided. Every attempt was made to remove this fluid. Chassaignac introduced his rubber drainage tube, Kceberle one made of glass, and Macewen tubes made of decal- cified chickenbone. Counter openings were made in the most dependent parts, so that the influence of gravity might be enlisted in the attempt to drain it away quickly. In the case of the abdomen, all such fluids were believed to gravitate into the pelvis, in women, into Douglas’ pouch. Some striking experiments have been reported, in which it was shown that the most septic fluids might pass through the peritoneum harmlessly so long as they were in constant movement. When once they remained stagnant, danger of a virulent type ensued. Under no circumstances were such fluids to remain, they must be quickly and constantly removed as long us they were secreted. Peaslee, in 1870, described four *In order to avoid tautology, tor the purposes of this paper, I have used the words bacteria, micrococci, germs, etc., as synonymous.
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