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A device to facilitate surgical dressings
A DEVICE TO FACILITATE HAROLD Clinical
Assistant
A.
GOLDBERGER,
Visiting NEW
T
Surgeon,
YORK
management of surgica1 wounds obviousIy entaiIs surgica1 procedures suited to each individual case. Assum-
I.
A device assuring
Surgical
Service,
Bellevue
Hospital
CITY
ready availability
ing that the surgeon has properIy treated the Iesion, the seemingIy unimportant probIem of surgica1 dressings arises, which, because it appears to be of secondary importance, has received IittIe of the attention it urgently requires. OnIy too frequentIy wounds are dressed with a so-caIIed dry dressing or covered with some inert, though harmIess, unguent. * From the Fourth
M.D.
In some cases the course and Iength of convalescence may not have been materially affected but in handling a Iarge series
HE
FIG.
SURGICAL DRESSINGS*
of medicated
strip packing.
of wounds of many types and of varying degrees of infection, such haphazard after care wiI1 resuIt in an appreciable increase of unnecessary hospita1 or clinic days; to say nothing of the attending Ioss of working days or of efficiency in the worker. In a busy surgical out-patient department or industria1 surgica1 dressing room, it has been found that the use of a simpIe
BelIevue 339
Hospital,
Dr. Car1 G. Burdick,
Director.
340
American Journal of Surgery
GoIdberger-SurgicaI
device shown in Figure I wiII permit handIing of cases with a great saving of time and effort. The device is encIosed in an amber colored jar with a removable cover. It consists of a meta stand of duraIuminum or pIated meta supporting a circuIar pIate in which there are openings of varying sizes to hoId Iipped amber tubes of convenient diameters. These tubes are fiIIed with gauze packing of varying widths, the sizes most commonIy used being >/4 inch, 34 inch, I inch and 2 inches. The tubes may be fiIIed in the surgical suppIy room and autoclaved with other gauze suppIies. They are then placed in the metal rack and azochIoramid in triacetin I :goo, is sIowIy added unti1 a11 the gauze has become thoroughIy saturated and a sIight excess of the soIution remains at the bottom of the tube. In this way we have avaiIabIe continuous Iengths of varied widths of “readymedicated dressings. One tube to-use” supported in the rack contains 70 per cent aIcoho1, to hoId a scissors and thumb forceps, with which the desired Iength of gauze packing may be cut. We wouId Iike to comment brieffy on the medication, azochIoramid. This new antiseptic has received favorabIe comment in the reports of a number of investigators and our own experience with this stabIe and non-irritating chIorine bactericide extends over three years. In packing the tubes we empIoy azochIoramid in triacetin I :500, as this soIution is sIightIy oiIy
Dressings
AUGUST,,937
(preventing adherence to dressings) and wiI1 not dry out. It is so stable that dressings remain effective on the wound surface for twenty-four hours or more, and as the device which we are describing is pecuIiarIy suitabIe for the out patient department, such a medication is we11 adapted to use with it. We have empIoyed a device of this sort for the past year on the Fourth Division SurgicaI Out-Patient Department of Bellevue Hospital and have found it to be very usefu1. It is inexpensive and a great time saver. We beIieve that it might be used advantageousIy in clinics, surgeries of Iarge industria1 plants, and as a part of the equipment of dressing carriages on surgical wards. REFERENCES Council on Pharmacy
and Chemistry.
J.A.M.A.,
105:
200, 1935. GOLDBERGER, H. A. The treatment of surgical infections with soIutions of a new chIorine compound of Iow potential. Western Jour. Surg., Gynec. and Oh., 44: 105-116, 1936. HOLOMAN,M. B. The use of azochIoramid in infections of the anorectaI regions. Med. World, 54: 719-72 I,
(Nov.) 1936. JOHNSON,PORTEOUS E. ProphyIaxis against infection in comnound fractures. Clin. Med. and Sum., 44: I 17-‘1rg (March) 1937. KENNEDY, R. H. Use of azochIoramid in infected wounds. Am. Jour. Surg., 3 I : zg4-zgg, I 936. SCHMELKES, F. C. and HORING, E. S. Jour. Bacterial., 29: 323-33’s 1935. SUTTON, L. E. and VAN DUYN, J. AzochIoramid in the treatment of Infected Wounds. New York State Jour. Med., 36: ~835-1838 (Dec.) 1936. YOUNG, FORREST. The treatment of surgical infections with new chIorine sotutions. Surg., Gynec. and Obst., 63: 318-324, 1936.
Assistant
A.
GOLDBERGER,
Visiting NEW
T
Surgeon,
YORK
management of surgica1 wounds obviousIy entaiIs surgica1 procedures suited to each individual case. Assum-
I.
A device assuring
Surgical
Service,
Bellevue
Hospital
CITY
ready availability
ing that the surgeon has properIy treated the Iesion, the seemingIy unimportant probIem of surgica1 dressings arises, which, because it appears to be of secondary importance, has received IittIe of the attention it urgently requires. OnIy too frequentIy wounds are dressed with a so-caIIed dry dressing or covered with some inert, though harmIess, unguent. * From the Fourth
M.D.
In some cases the course and Iength of convalescence may not have been materially affected but in handling a Iarge series
HE
FIG.
SURGICAL DRESSINGS*
of medicated
strip packing.
of wounds of many types and of varying degrees of infection, such haphazard after care wiI1 resuIt in an appreciable increase of unnecessary hospita1 or clinic days; to say nothing of the attending Ioss of working days or of efficiency in the worker. In a busy surgical out-patient department or industria1 surgica1 dressing room, it has been found that the use of a simpIe
BelIevue 339
Hospital,
Dr. Car1 G. Burdick,
Director.
340
American Journal of Surgery
GoIdberger-SurgicaI
device shown in Figure I wiII permit handIing of cases with a great saving of time and effort. The device is encIosed in an amber colored jar with a removable cover. It consists of a meta stand of duraIuminum or pIated meta supporting a circuIar pIate in which there are openings of varying sizes to hoId Iipped amber tubes of convenient diameters. These tubes are fiIIed with gauze packing of varying widths, the sizes most commonIy used being >/4 inch, 34 inch, I inch and 2 inches. The tubes may be fiIIed in the surgical suppIy room and autoclaved with other gauze suppIies. They are then placed in the metal rack and azochIoramid in triacetin I :goo, is sIowIy added unti1 a11 the gauze has become thoroughIy saturated and a sIight excess of the soIution remains at the bottom of the tube. In this way we have avaiIabIe continuous Iengths of varied widths of “readymedicated dressings. One tube to-use” supported in the rack contains 70 per cent aIcoho1, to hoId a scissors and thumb forceps, with which the desired Iength of gauze packing may be cut. We wouId Iike to comment brieffy on the medication, azochIoramid. This new antiseptic has received favorabIe comment in the reports of a number of investigators and our own experience with this stabIe and non-irritating chIorine bactericide extends over three years. In packing the tubes we empIoy azochIoramid in triacetin I :500, as this soIution is sIightIy oiIy
Dressings
AUGUST,,937
(preventing adherence to dressings) and wiI1 not dry out. It is so stable that dressings remain effective on the wound surface for twenty-four hours or more, and as the device which we are describing is pecuIiarIy suitabIe for the out patient department, such a medication is we11 adapted to use with it. We have empIoyed a device of this sort for the past year on the Fourth Division SurgicaI Out-Patient Department of Bellevue Hospital and have found it to be very usefu1. It is inexpensive and a great time saver. We beIieve that it might be used advantageousIy in clinics, surgeries of Iarge industria1 plants, and as a part of the equipment of dressing carriages on surgical wards. REFERENCES Council on Pharmacy
and Chemistry.
J.A.M.A.,
105:
200, 1935. GOLDBERGER, H. A. The treatment of surgical infections with soIutions of a new chIorine compound of Iow potential. Western Jour. Surg., Gynec. and Oh., 44: 105-116, 1936. HOLOMAN,M. B. The use of azochIoramid in infections of the anorectaI regions. Med. World, 54: 719-72 I,
(Nov.) 1936. JOHNSON,PORTEOUS E. ProphyIaxis against infection in comnound fractures. Clin. Med. and Sum., 44: I 17-‘1rg (March) 1937. KENNEDY, R. H. Use of azochIoramid in infected wounds. Am. Jour. Surg., 3 I : zg4-zgg, I 936. SCHMELKES, F. C. and HORING, E. S. Jour. Bacterial., 29: 323-33’s 1935. SUTTON, L. E. and VAN DUYN, J. AzochIoramid in the treatment of Infected Wounds. New York State Jour. Med., 36: ~835-1838 (Dec.) 1936. YOUNG, FORREST. The treatment of surgical infections with new chIorine sotutions. Surg., Gynec. and Obst., 63: 318-324, 1936.