Manual of Surgery eBook

This eBook from the Gutenberg Project consists of approximately 697 pages of information about Manual of Surgery.

Manual of Surgery eBook

This eBook from the Gutenberg Project consists of approximately 697 pages of information about Manual of Surgery.

#Lightning-stroke.#—­In a large proportion of cases lightning-stroke proves instantly fatal.  In non-fatal cases the patient suffers from a profound degree of shock, and there may or may not be any external evidence of injury.  In the mildest cases red spots or wheals—­closely resembling those of urticaria—­may appear on the body, but they usually fade again in the course of twenty-four hours.  Sometimes large patches of skin are scorched or stained, the discoloured area showing an arborescent appearance.  In other cases the injured skin becomes dry and glazed, resembling parchment.  Appearances are occasionally met with corresponding to those of a superficial burn produced by heat.  The chief difference from ordinary burns is the extreme slowness with which healing takes place.  Localised paralysis of groups of muscles, or even of a whole limb, may follow any degree of lightning-stroke.  Treatment is mainly directed towards combating the shock, the surface-lesions being treated on the same lines as ordinary burns.

CHAPTER XII

METHODS OF WOUND TREATMENT

Varieties of wounds—­Modes of infection—­Lister’s work—­Means taken to
    prevent infection of wounds:  heat; chemical antiseptics;
    disinfection of hands; preparation of skin of patient;
    instruments; ligatures; dressings—­Means taken to combat
    infection:  purification; open-wound method.

The surgeon is called upon to treat two distinct classes of wounds:  (1) those resulting from injury or disease in which the skin is already broken, or in which a communication with a mucous surface exists; and (2) those that he himself makes through intact skin, no infected mucous surface being involved.

Infection by bacteria must be assumed to have taken place in all wounds made in any other way than by the knife of the surgeon operating through unbroken skin.  On this assumption the modern system of wound treatment is based.  Pathogenic bacteria are so widely distributed, that in the ordinary circumstances of everyday life, no matter how trivial a wound may be, or how short a time it may remain exposed, the access of organisms to it is almost certain unless preventive measures are employed.

It cannot be emphasised too strongly that rigid precautions are to be taken to exclude fresh infection, not only in dealing with wounds that are free of organisms, but equally in the management of wounds and other lesions that are already infected.  Any laxity in our methods which admits of fresh organisms reaching an infected wound adds materially to the severity of the infective process and consequently to the patient’s risk.

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Manual of Surgery from Project Gutenberg. Public domain.