Fig. 20.—Clark Kumol Apparatus.
The Kumol method (Kronig) is considered the most reliable, even under the severest tests. This mode of sterilization is accomplished as follows: A specially devised apparatus of brass, with a cast-bronze top, both thoroughly nickel-plated, is used. The apparatus of J. G. Clark, as shown in [Fig. 20], will be found excellent. The kumol is retained in a seamless cylinder, 8 by 8 inches, which is surrounded on the sides and bottom by a sand bath; the flame, impinging on the bottom, heats the sand, thereby insuring an even heat to the inner or sterilizing cylinder. The catgut, in rings, is placed in a perforated basket hanging in the cylinder, which can be raised or lowered at will; after drying for two hours at 80° C., the basket is dropped, and the catgut immersed in the kumol, at 155° C., for one hour; the kumol is then drawn off through a long rubber tube, and the catgut dried at 100° C., for two hours; it is then transferred to sterile glass tubes plugged with cotton.
Prepared catgut of the various sizes can now, however, be purchased in the market, and that offered by the better firms of chemists is quite reliable and may be safely used for all plastic surgery about the face. It is supplied in glass tubes, either in given lengths, as in the Fowler type, in which the hermetically sealed tube is U-shaped or on glass spools placed in glass tubes, not sealed, but closed by a rubber cap, through which the desired length of ligature is drawn and then cut off.
CHAPTER IV
PREFERRED ANTISEPTICS
ANTISEPTIC SOLUTIONS
These are solutions used for the destruction of and to arrest the progress of microörganisms that have found their way into wounds—the cause of sepsis, as exhibited by fever, suppuration, and putrefaction. These preparations are called antiseptics and are used to render parts aseptic. They vary much in their destructive power, effect on tissue, and toxic properties. The reader is referred to a work on bacteriology for the specific knowledge of such on germ life.
The antiseptic treatment of wounds was founded by Joseph Lister, 1865-70, then called Listerism. His one chemical agent to accomplish this was carbolic acid, but many such and more effective agents have been added since that time, all differing in their specific properties and each having, for the same reason, its particular use.
The following group of antiseptics has been chosen with a view of giving the best selection, to which the author has added a short description of each, so that the surgeon may choose one or the other, as the occasion may demand. As a rule, an operator cultivates the use of a certain line of antisepsis, especially in this branch of surgery, experience being the best guide; yet it is hoped he may find certain aid from those referred to, their particular use being pointed out from time to time, as the author has had occasion to prefer one or the other.