An address on the treatment of wounds in war : delivered before the Medical Society of London on November 16, 1914 / by Sir W. Watson Cheyne.

  • Cheyne, William Watson, Sir, 1852-1932.
Date:
1914
Catalogue details

Licence: In copyright

Credit: An address on the treatment of wounds in war : delivered before the Medical Society of London on November 16, 1914 / by Sir W. Watson Cheyne. 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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    clamped and the wound temporarily stuffed with gauze or large sponges. The next step is to cleanse and dis- infect the skin thoroughly. In the first place scrub it thoroughly with i in 20 carbolic lotion and ether soap, then shave it, and finally wash it thoroughly again with the carbolic lotion, leaving a cloth saturated with the lotion over the whole area, so as to continue the disinfect- ing action and protect the skin while the interior of the wound is being attended to. The interior of the wound must now be disinfected, and if it is necessary to gain access to the deeper parts in order to enable one to see what one is doing, which is very important, the wound must be enlarged by incisions made in suitable directions. The blood must be thoroughly swabbed out, the wound made as dry as possible, and the skin or fat or other structures which are visibly soiled with earth or dirt should be cut away'. The wound being then held wide open by' retractors, a piece of sponge dipped in the liquefied carbolic acid is carefully and thoroughly applied to the whole surface of the wound and to all the recesses, care being taken, by holding a swab in the other hand on the edge of the wound, to prevent the acid running over the skin. It is well to sponge out the wound after the first application, and then to apply' the acid a second and even a third time if there is bad soiling. If at the bottom of the wound there is a long narrow track leading to the tissue.s, it may not be necessary' to disinfect it along its whole length, because the probability is that the bullet or fragment of shell does not carry the organisms in to a very great depth. If it is a large wound which has to be soaked with the undiluted carbolic acid, it may be well, after about five to ten minutes, to wash it out first with i in 20 carbolic lotion, and then copiously with saline solution, so as to get rid of the excess of carbolic acid and thus reduce the chance of absorption. Having completed the disinfection of the wound, the tourniquet is relaxed, the vessels tied, and a good-sized drainage tube inserted down to the bottom of the wound,