October 1,
A MIRROR OF HOSriTAL PRACTICE.
1880.]
DECALCIFIED BONE DRAINAGE TUBES. By Surgeon Shirley
Deakut, F.R.C.S. Eng.,
I. M. D.
An efficient, cheap, and ready method of preparing bone drains invented by Dr. Neuber, of Kiel, is to use the long bones of the limbs of poultry and game-birds. Dr. Neuber had his tubes The
other bone.
or
prepared from sound tubes, being first turned of decalcified by immersion
size and length, were chloric Acid and water.
The fibrous matrix of the
thus left which retains its
boiling
becomes
chiefly
ox, horse, the proper in Hydro-
shape,
and which on
bone is
prolonged
converted into
gelatin. required are well boiled to rid them of the soft parts. They are then placed for ten hours in a mixture of one part of hydrochloric acid and two parts of water. This renders the bones soft and pliable, almost all the earthy salts having been dissolved out, so that the ends of the bone can be cut of with a pair of scissors. This having been done, the medullary canal of the shaft should then be well cleaned out with a thick wire, or, better, with a Long
bones of the size
fine rat-tailed file, and the bone tube should then be well a 5 per cent, solution of Carbolic acid to which The tubes should be kept in some borax has been added.
boiled in
5 per cent Carbolic oil. When used the bone drains
gradually become absorbed In Dr. Neuber's cases, replaced. just dressed under the antiseptic method, the first dressings were in most instances allowed to remain unchanged for fourteen as
catgut is absorbed
days, when in many
or
cases
the wound
was
found to be
healed
antiseptic dressing did not require to be renewed, its place being taken by boracic lint or some similar dressing. Thus, under this method of dressing, as quoted by MacOormac in his Antiseptic Surgery, from Langenbeck's Archives, a great improvement in antiseptic practice has
and the
been introduced.
drainage tubes, without the use of antisepby no means free from danger. The means the egress of discharges being, under such circumstances, liable to become the means of ingress of septic material. These dangers are fully pointed out in a paper on the Antiseptic Method in Abdominal Surgery, Lancet, II. 1879, p. 461, by Mr. Knowsley Thornton, who considers The free use of
tic
dressings, provided for
is
that in fresh ovariotomy cases, that is cases Which have not previously tapped without antiseptic precautions, the need of drainage has passed away. When in other cases he " as soon as the disuses a drain, he would withdraw it
been
charge ceased to overflow into the sponge if the general condition of the patient, and the progressive decrease of discharge, gave evidence of asepticity." Flexible and absorbable bone tubes would, however, be free from many of the objections which may be urged against the use of glass drainage tubes, such as causing irritation and ulceration or obstruction of the bowel they rest, or with which they come in contact; and decalcified bone drains keep the edges of the wound
which
on as
apart there being a suture might
days at most, there is less chance of place left in the cicatrix, though a tube always be inserted at the time of operation to obviate this accident, and the edges of the wound brought together when the tube has disappeared or been removed.
for a few weak
2G9
A MIRROR OF HOSriTAL PRACTICE.
1880.]
DECALCIFIED BONE DRAINAGE TUBES. By Surgeon Shirley
Deakut, F.R.C.S. Eng.,
I. M. D.
An efficient, cheap, and ready method of preparing bone drains invented by Dr. Neuber, of Kiel, is to use the long bones of the limbs of poultry and game-birds. Dr. Neuber had his tubes The
other bone.
or
prepared from sound tubes, being first turned of decalcified by immersion
size and length, were chloric Acid and water.
The fibrous matrix of the
thus left which retains its
boiling
becomes
chiefly
ox, horse, the proper in Hydro-
shape,
and which on
bone is
prolonged
converted into
gelatin. required are well boiled to rid them of the soft parts. They are then placed for ten hours in a mixture of one part of hydrochloric acid and two parts of water. This renders the bones soft and pliable, almost all the earthy salts having been dissolved out, so that the ends of the bone can be cut of with a pair of scissors. This having been done, the medullary canal of the shaft should then be well cleaned out with a thick wire, or, better, with a Long
bones of the size
fine rat-tailed file, and the bone tube should then be well a 5 per cent, solution of Carbolic acid to which The tubes should be kept in some borax has been added.
boiled in
5 per cent Carbolic oil. When used the bone drains
gradually become absorbed In Dr. Neuber's cases, replaced. just dressed under the antiseptic method, the first dressings were in most instances allowed to remain unchanged for fourteen as
catgut is absorbed
days, when in many
or
cases
the wound
was
found to be
healed
antiseptic dressing did not require to be renewed, its place being taken by boracic lint or some similar dressing. Thus, under this method of dressing, as quoted by MacOormac in his Antiseptic Surgery, from Langenbeck's Archives, a great improvement in antiseptic practice has
and the
been introduced.
drainage tubes, without the use of antisepby no means free from danger. The means the egress of discharges being, under such circumstances, liable to become the means of ingress of septic material. These dangers are fully pointed out in a paper on the Antiseptic Method in Abdominal Surgery, Lancet, II. 1879, p. 461, by Mr. Knowsley Thornton, who considers The free use of
tic
dressings, provided for
is
that in fresh ovariotomy cases, that is cases Which have not previously tapped without antiseptic precautions, the need of drainage has passed away. When in other cases he " as soon as the disuses a drain, he would withdraw it
been
charge ceased to overflow into the sponge if the general condition of the patient, and the progressive decrease of discharge, gave evidence of asepticity." Flexible and absorbable bone tubes would, however, be free from many of the objections which may be urged against the use of glass drainage tubes, such as causing irritation and ulceration or obstruction of the bowel they rest, or with which they come in contact; and decalcified bone drains keep the edges of the wound
which
on as
apart there being a suture might
days at most, there is less chance of place left in the cicatrix, though a tube always be inserted at the time of operation to obviate this accident, and the edges of the wound brought together when the tube has disappeared or been removed.
for a few weak
2G9
