Shave the skin in every case, whether thickly covered with hair or not. This shaving is most important, as it removes all fine grease-coated hairs which might favour the growth of germs, and also scrapes off the surface dirt and dead scales of skin.
After shaving, again scrub with soap and water, and wash the skin with an antiseptic lotion, such as carbolic (1 in 60), or chinosol (1 in 1000).
Having cleansed the skin, now clean up the wound itself. Thoroughly wash the wound with an antiseptic lotion, either rubbed in with lint or wool, or injected with a glass syringe.
All instruments, ligatures and needles should be boiled for at least five minutes in water (to which a little washing-soda may be added with advantage), and should then be dropped into an antiseptic solution. When boiling is not possible, they should be soaked in carbolic lotion, 1 in 30, for ten minutes, and then transferred to 1 in 60.
The hands of the operator must be scrubbed for some minutes with soap and warm water, and then in an antiseptic solution, particular attention being paid to the nails, which should have been cut quite short. Cleanliness of the operator’s hands is the first essential of successful treatment of wounds.
The edges of small, clean-cut wounds may be brought together with adhesive plaster, but larger wounds will need antiseptic silk or gut ligatures to keep the edges applied evenly.
Large ragged wounds, with much bruising; wounds containing dirt, sand, etc., or deep wounds such as those caused by bullets or spears, should not be completely closed. They should be cleansed, as above, dusted with iodoform powder, and a strip of antiseptic gauze arranged so as to reach from the surface of the skin to the deepest part of the wound. This, which serves as a drain for the discharges, should be renewed every day until healing is fairly established. If necessary, a few stitches may be inserted in the more superficial parts of the wound to bring the edges of the skin into contact.
The wound should be dressed with strips of antiseptic gauze, slightly moistened with whichever antiseptic solution is used, and over this should be placed a pad of antiseptic wool, which should be kept firmly and evenly in place by a well-applied bandage.
A wounded limb should be kept at rest, as far as possible, either by sand-bags or a splint.