ted tincture of
iodin in ounce quantities, it must be remembered, is not to be done
unless there is provision for its free exit. Where good drainage from
the joint cavity exists all infected wounds should be thus treated, and
this treatment may be repeated as conditions seem to require--until
infection is checked.
If daily injections are necessary, dilution of the tincture of iodin
with an equal amount of alcohol is advisable in order to avoid doing
irreparable damage to the articular cartilages and synovial membranes.
An antiseptic powder composed of equal parts of boric acid and
exsiccated alum is employed to protect the wound surfaces and the
margins, and the parts are then bandaged. In bandaging wounds of this
kind a liberal amount of cotton should be employed, and after a large
surface surrounding the wound has been thoroughly cleansed, it must be
so kept thereafter. This is impossible, if one uses a small amount of
cotton, particularly if such meager quantity of dressing material is
carelessly wrapped in position with an insufficient amount of bandage
material. Mention, without description of the elemental problem of
applying cotton and bandages to a wound, would be sufficient, were it
not that this is a very important part of the handling of such cases,
and many practitioners are not only thoughtless in this part of their
work, but also apparently careless. What does it profit to prepare a
part and cleanse a wound with painstaking care and then neglect to take
every possible precaution to prevent its subsequent contamination?
In the handling of open joint capsules where the perforation of the
capsular ligament is small and discharge of synovia does not immediately
follow, there is presented a problem which is difficult to decide upon
and that is the manner in which such wounds are to be handled. One
hesitates to enlarge such openings to drain or irrigate the capsule when
there is no proof that serious trouble will follow because of infectious
material which has probably been introduced at the time the wound was
inflicted. It is especially difficult to decide upon the manner of
handling such cases where the tarsal joint is wounded, although one
hesitates to invade any joint to the extent of incising its capsule,
unless there is urgent need of so doing.
Frost[19] offers the following suggestion in such instances:
The treatment recommended by us for open joints, in which we wish
to prevent ankylo
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