Observations on some of the more recent methods of treating wounds : and on excision of the knee-joint / by Edward Lund.

  • Lund, Edward, 1823-1898.
Date:
[1870]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on some of the more recent methods of treating wounds : and on excision of the knee-joint / by Edward Lund. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    larger wound^ the surface being more extensive, with a greater area of newly exposed tissues and the haemorrhage more considerable, the blood flows more rapidly and has not time to coagulate and solidify, as far as its fibrine is concerned, before the newly made coverings are washed away by the continued stream. And more important even than this is the circumstance that the coagulum thus partially formed (either from its extent or its thickness) is too great to undergo that rapidly drying process by which its albumen will be converted into a layer of varnish on the surface of the wound ; but on the contrary, by remaining as a thick mass at the usual temperature of the surface of the body, it is left in the most favorable state for subsequent putrefaction. The mass thus formed and not dried, lies on the surface as a foreign body, and becomes amenable to all those laws of chemical change which would affect its decomposition independently of the controlling influences of vit^ forces. The average temperature of the body being a known quantity, a constant factor in these changes, acts either for good, as in the case of the small wound, where it tends to dry up the albuminous part of the escaping blood, and form it into a plaster or protecting shield; or, as in the case of the larger wound, as an element of evil, for then the same atmosphere and its contents, with the presence of moisture, will favour those putrefac- tive changes which it should be our object to prevent as far as possible. Yet in modern times, and even at a comparatively recent date, surgeons have been found who have advocated the practice of treating wounds, especially those produced in amputations, without any dressings at all, simply by entire exposure to the air from first to last, or at least until a very advanced period in the treatment. In this they acted doubtless upon the principle just enunciated, that if the escape of blood and serum can be so regulated, as to time and quantity, as to become thoroughly dried, and remain in that condition for a certain time, they will prove of all others the best protecting medium for the wounded surfaces. This, however, can only be etficient where the covering thus formed fairly overlaps the edges of the wound, and thus excludes the air from every part j for if there be any portion of it upon which the blood has not thus 2