Fig. 155.—Showing how Digital Compression should be applied to the Brachial Artery.
Do not presume upon any smattering of knowledge you have, to assume any risk that might lead to serious results. Make the sufferer comfortable by giving him an abundance of fresh air and placing him in a restful position. Do all that is possible to keep back the crowd of curious lookers-on, whom a morbid curiosity has gathered about the injured person. Loosen all tight articles of clothing, as belts, collars, corsets, and elastics. Avoid the use of alcoholic liquors. They are rarely of any real service, and in many instances, as in bleeding, may do much harm.
360. Incised and Lacerated Wounds. An incised or cut wound is one made by a sharp instrument, as when the finger is cut with a knife. Such a wound bleeds freely because the clean-cut edges do not favor the clotting of blood. In slight cuts the bleeding readily ceases, and the wound heals by primary union, or by “first intention,” as surgeons call it.
Lacerated and contused wounds are made by a tearing or bruising instrument, for example, catching the finger on a nail. Such wounds bleed but little, and the edges and surfaces are rough and ragged.
If the incised wound is deep or extensive, a physician is necessary to bring the cut edges together by stitches in order to get primary union. Oftentimes, in severe cuts, and generally in lacerations, there is a loss of tissue, so that the wound heals by “second intention”; that is, the wound heals from the bottom by a deposit of new cells called granulations, which gradually fill it up. The skin begins to grow from the edges to the center, covering the new tissue and leaving a cicatrix or scar with which every one is familiar.
361. Contusion and Bruises. An injury to the soft tissues, caused by a blow from some blunt instrument, or a fall, is a contusion, or bruise. It is more or less painful, followed by discoloration due to the escape of blood under the skin, which often may not be torn through. A black eye, a knee injured by a fall from a bicycle, and a finger hurt by a baseball, are familiar examples of this sort of injury. Such injuries ordinarily require very simple treatment.
The blood which has escaped from the capillaries is slowly absorbed, changing color in the process, from blue black to green, and fading into a light yellow. Wring out old towels or pieces of flannel in hot water, and apply to the parts, changing as they become cool. For cold applications, cloths wet with equal parts of water and alcohol, vinegar, and witch-hazel may be used. Even if the injury is apparently slight it is always safe to rest the parts for a few days.
When wounds are made with ragged edges, such as those made by broken glass and splinters, more skill is called for. Remove every bit of foreign substance. Wash the parts clean with one of the many antiseptic solutions, bring the torn edges together, and hold them in place with strips of plaster. Do not cover such an injury all over with plaster, but leave room for the escape of the wound discharges. For an outside dressing, use compresses made of clean cheese-cloth or strips of any clean linen cloth. The antiseptic corrosive-sublimate gauze on sale at any drug store should be used if it can be had.
Wounds made by toy pistols, percussion-caps, and rusty nails and tools, if neglected, often lead to serious results from blood-poisoning. A hot flaxseed poultice may be needed for several days. Keep such wounds clean by washing or syringing them twice a day with hot antiseptics, which are poisons to bacteria and kill them or prevent their growth. Bacteria are widely distributed, and hence the utmost care should be taken to have everything which is to come in contact with a wounded surface free from the germs of inflammation. In brief, such injuries must be kept scrupulously neat and surgically clean.