The Lettsomian lectures on aseptic surgery in theory and practice / by Charles Barrett Lockwood.

  • Lockwood, Charles Barrett, 1856-1914.
Date:
1904
Catalogue details

Licence: In copyright

Credit: The Lettsomian lectures on aseptic surgery in theory and practice / by Charles Barrett Lockwood. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    Some of the tests—I know not exactly how many—were made at the end of the operation. Once the infection was due to moulds and cocci, and probably came from the air. In the others some variety of white staphylococcus grew in subcultures, some of these cocci without doubt came from the skin of the surgeons or of the patient. I am not here to throw a gloss over our results, and therefore confess that these are extremely bad. Catgut and Silkworm Gut. In spite of the efforts of numerous investigators and inventors catgut still remains an object of suspicion. This is to be deplored, because it is an admirable substance for a variety of surgical purposes. I invariably use catgut for septic wounds. To my mind it is invaluable for operations about the rectum and perineum. Likewise it is best to use catgut when there is reason to suppose that the wound is tuberculous. When tuberculous pus or caseous material escapes into the wound silk ligatures are apt to become infected and keep open the wound until withdrawn or extruded. In operations for the removal of growths from the urinary bladder catgut can be safely applied to bleeding vessels and for the closure of wounds in the mucous coat. I habitually use it in cases of appendectomy when pus is met with or the wound is obviously septic. For certain wounds in infants and children—such as circum- cision—it makes excellent material for ligatures and sutures. The removal of cutaneous sutures from a nervous frightened child is a. troublesome business. Speaking generally it is advisable to use catgut for the control of haemorrhage in all septic wounds in preference to materials which do not speedily soften and disappear. Who has not seen a sinus persist for months because it had a septic silk ligature in its depths ? A scrap of silk has not infrequently formed the nucleus of a vesical calculus. One would hardly think it necessary to lay any stress upon the propriety of using catgut for septic wounds and silk for aseptic if one did not occasional^ see the reverse put into practice. But there are probably other reasons why catgut is looked at askance. Although some specimens may contain no infective organisms, they may contain ptomaines which set up a localised suppuration. Besides, catgut is not particularly good material to