Femina, A Work for Every Woman

by John A. Miller

In compound fractures, the wound should be carefully covered with a soft clean compress which is kept thoroughly wetted with clean cold water until the surgeon arrives.

Sometimes the circumstances make it necessary to remove or transport a patient; then the injured limb must be properly supported so that it will remain motionless on the journey. In case the arm is fractured the above object is readily accomplished by placing it in a sling suspended from the neck. In the case of the lower extremities this object is more difficult. The leg should be wrapped in cotton first, or some other soft clean substance, after which a slat should be placed on the outside and inside of the limb, the same length as the limb; over and around these slats strips of muslin or a bandage is wound so as to keep them in place. This contrivance forms a temporary or improvised splint until the surgeon takes charge of the case.

(b) Wounds are defined as a recent sudden solution of continuity in the soft parts or flesh of the body. For the sake of convenience in description and for practical purposes, wounds are divided into incised, lacerated, contused, punctured, and poisoned wounds.

An incised wound is a clean smooth cut made by a sharp clean-cutting instrument.

A lacerated wound is one in which the parts have been torn asunder or in which the instrument was blunt or dull.

A contused wound is one the result of a bruise or blow inflicted with a blunt object or by a flat surface.

A punctured wound is one in which the flesh is pierced with a sharp-pointed instrument, like that made with a stiletto or bayonet.

Poisoned wounds are such as have become infected any time after the receipt of the injury, or which are the result of a bite or sting from a reptile or insect.

The danger of wounds depends on their extent and depth, and upon the locality or organ in which the wound is situated. The external wounds, that is those which admit of inspection, and situated on the head, trunk or extremities are of most frequent occurrence, and the most amenable to treatment.

The treatment of wounds has made wonderful progress since the antiseptic discoveries of the eminent surgeon, Sir Joseph Lister, and these sound principles have materially influenced almost every department of the healing art. It was he who first showed how dust-laden air affected injuriously the exposed tissues of the wounds; it was he who introduced all the precautions as to cleanliness of instruments; the disinfection of hands; the change of clothing; and the purification of sponges and dressings. The magnificent results of the practice of modern surgery are not owing to the superior skill of the surgeon of our time, but to the magnificent conception of the idea of cleanliness from which has grown the entire superstructure of antiseptic surgery, culminating in the grand triumphs of surgical art. To the question What to do with recent wounds? The answer now becomes self-evident; Keep them clean. The best dressing for any clean wound is its own secretion carefully protected from the outside world by a fold of clean soft cloth or absorbent cotton, wetted with pure cold water. This is to be kept in its proper place by means of a bandage, and when it is desirable to remove the compress, it must first be thoroughly soaked with water so as not to tear or irritate the wound.