As we have already pointed out, bacteria and their products are not only obstacles to the healing process, but the active causes of the diseases incidental to it. It is desirable, therefore, that everything brought into contact with the wound in the way of treatment should be rendered free from these offending organisms.
Sponges, cloths, and brushes, instruments, and sutures, as well as the hands of the operator, should each and all be dealt with antiseptically before being brought into use.
Sponges in their ordinary condition teem with bacteria of various kinds, and unless rendered thoroughly aseptic, may prove a fruitful source of mischief. Before being employed for surgical purposes they should be well washed out in soap and water, and then transferred to a fairly strong solution of soda, and after soaking in this for a couple of hours they should be wrung out in cold water, and kept immersed in a l-in-20 solution of carbolic acid for four or five days or until required. Immediately before use they should be rinsed in a l-in-2000 sublimate solution, or l-in-40 carbolic lotion.
Where sponges so treated are not accessible, pads of absorbent wool steeped in carbolic or sublimate solution may be substituted. By some practitioners these are preferred, and generally employed, for the reason that after use they can be thrown away, and thus the trouble and risk of infection by sponges are averted.
Whether sponges or swabs of wool are used, the act of cleansing should always be carried out by wiping the skin in the direction away from the wound, and neither the one nor the other should be allowed to touch the latter until again soaked in the disinfectant.
Cloths and towels used for the hands and other purposes require to be soaked for three or four hours in a solution of carbolic acid (l in 20), and all instruments employed in the operation must be similarly dealt with.
Ligatures and sutures of catgut should be soaked in carbolic solution of the strength last referred to for four or five days, and silk should be treated in the same way, after first being boiled for twenty or thirty minutes. By the adoption of this course, suppuration in the track of the stitches is guarded against, and healing is facilitated.