Such dressings are allowed to remain until the sutures are taken out, unless there is sign of soiling. As these secretions readily decompose, it is best to remove the cotton and upper layers of gauze and renew them every day, or as often as is necessary. The wound, in this way, is not disturbed whatever, and the antiseptic properties of the lower fold of gauze is sufficient to keep the wound surface clean.
In most superficial wounds it is best to remove the sutures at the end of forty-eight hours, unless there are reasons for retaining them longer, as the coapted surfaces are then sufficiently united to permit of other dressings, such as aseptic plaster, now extensively used. Before these are applied the skin is washed with alcohol or ether to assure a dry surface to facilitate adhesion.
Sutures drawn as stated leave no possibility of stitch scars and reduce the occurrence of possible stitch abscess to a minimum. As there is always slight oozing following their removal, aristol or iodol may be powdered over them before applying the plasters. This brings us to the rather late question of sutureless coaptation of superficial incisions.
Sutureless Coaptation.—This method, first practically demonstrated by Bretz, may be used with considerable advantage in wounds about the face, and overcomes the strain of individual sutures, besides avoiding the possibilities of stitch infection.
Fig. 21. Fig. 22.
Plaster Sutures.
The method involves the proper placing of strips of plaster at either or opposite ends of the wound. The distance between the incision and the edge of the plaster must not be less than ¼ inch or more, according to the length of the wound and its position. In place of the strips of rubber adhesive plaster, the aseptic Z. O. plaster should be substituted to overcome the objections of the infections therefrom.
