Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


_Evacuation of the Abscess and Injection of Iodoform._--The iodoform is
employed in the form of a 10 per cent. solution in ether or the same
proportion suspended in glycerin. Either form becomes sterile soon after
it is prepared. Its curative effects would appear to depend upon the
liberation of iodine, which restrains the activity of the bacilli, and
upon its capacity for irritating the tissues and so inducing a
protective leucocytosis, and also of stimulating the formation of scar
tissue. An anaesthetic is rarely called for, except in children. The
abscess is first evacuated by means of a large trocar and cannula
introduced obliquely through the overlying soft parts, avoiding any part
where the skin is thin or red. If the cannula becomes blocked with
caseous material, it may be cleared with a probe, or a small quantity of
saline solution is forced in by the syringe. The iodoform is injected by
means of a glass-barrelled syringe, which is firmly screwed on to the
cannula. The amount injected varies with the size of the abscess and the
age of the patient; it may be said to range from two or three drams in
the case of children to several ounces in large abscesses in adults. The
cannula is withdrawn, the puncture is closed by a Michel's clip, and a
dressing applied so as to exert a certain amount of compression. If the
abscess fills up again, the procedure should be repeated; in doing so,
the contents show the coloration due to liberated iodine. When the
contents are semi-solid, and cannot be withdrawn even through a large
cannula, an incision must be made, and, after the cavity has been
emptied, the iodoform is introduced through a short rubber tube attached
to the syringe. Experience has shown that even large abscesses, such as
those associated with spinal disease, may be cured by iodoform
injection, and this even when rupture of the abscess on the skin surface
has appeared to be imminent.

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