2
397 The splint consists of eleven pieces of flat metal (see Fig. 1) which can be bolted together by means of series of holes bored at corresponding intervals, so that any section may be bolted to any of its fellows to form any length and FiG. 1. any angle. (Fig. 2.) Thus straight splints may be made from 8 in. to 4 ft. 8 in. in length, internal or external angular splints with fenestra for the condyle at any angle, obtuse, acute, or right ; Carr’s or pistol splints for wrist or FIG. 2. metacarpus, and finger or thumb splints. By means of two sections bent on the flat, anterior and posterior angular splints, or leg splints with sole, plate, or foot-piece, may be constructed with fenestra for the malleolus. The bolts and nuts are carried in a flat holder, from which they are unable to fall out. They occupy a minimum of space, and two sections can be firmly bolted together with the fingers only in 30 seconds or less. FIG. 3. The whole apparatus, in bright aseptic metal, with bolts, padding, and triangular bandage, kept together by the buckles and bands used in their application, is contained in a neat khaki case which can be carried in the pocket. (Fig. 3.) The splint has been constructed to my design by the Holborn Surgical Instrument Co., Limited, 26, Thavies Inn, Holborn Circus, London, E. C. F. THOMPSON, M.R.C.S., L.R.C.P. Lond. Sunbury-on-Thames. F. THOMPSON, M.R.C.S., L.R.C.P. Lond. A NOTE ON WICK DRAINS. THE ordinary drain or " plugging " of folded gauze takes a certain period of time to make. When the gauze is at all hard or its fibre coarse, partially glazed or mercerised, as is notably the case with some of the American gauzes, the difficulty of folding is increased. Machine-made plugging is expensive and the sizes to hand are not always those required. It occurred to me that at this time, when large quantities of plugging are required for use with hypertonic or other treatment or for stopping a secondary haemorrhage, it would be advisable to use some form of cheap lamp wick, but the woven varieties are rather closely knit and the twisted varieties are apt to be unmanageable with a probe. Some of the wicks sold do not absorb water. A simple solution of the problem, apart from constructing a machine for the purpose or adapting a knitting machine, is to utilise a child’s knitting reel with which reins or " cats’ tails " are made. Three pins to the reel seem to be better than a larger number, but if a more truly circular and tubular wick is desired a larger number may be used. In this case the product is either closer in texture or unduly large. The illustration shows three reels of convenient sizes, the drains being 1/2 inch, 3/8 inch, and 1/4 inch in diameter respectively. These sizes are made by employing reels of the following measurements (in inches) :- Diameter of wick ...... ½ ...... 3/8 ...... ¼ Size of reel- Height............ 1 ...... 1Q ...... 1 3/4 Outside diameter ... 2 ...... 12 ...... 1¼ Diameter of hole ... LI- ...... ½ ...... 3/8 Side of triangle ...... 1½ ...... ....... % Size of cotton ......... 2 ...... 4 ...... 10 In the above table the only important measure is the distance between the feet of the (equilateral) triangle formed by the pins, because on this depends the size of the stitch in the tail. The other measurements merely indicate the sizes of reels convenient to work with. Any reel large enough to take the triangle and having a hole large enough not to compress the tail will do. Any kind of pin or tack will answer the purpose, but a convenient thing to use is a full-gauge, 5/8 inch, brass escutcheon pin, sold by most ironmongers. The cotton used is Alexander’s 4-thread knitting cotton (bleached), and the sizes to correspond with reels of the above- mentioned measurements are No. 2 (thick), No. 4 (medium), and No. 10 (thin), the approximate diameters of these threads being 1/8 inch, 1/16 inch, and 1/32 inch (the last one plus). This cotton is a smooth loose twist of four strands which

A NOTE ON WICK DRAINS

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Page 1: A NOTE ON WICK DRAINS

397

The splint consists of eleven pieces of flat metal (seeFig. 1) which can be bolted together by means of series ofholes bored at corresponding intervals, so that any sectionmay be bolted to any of its fellows to form any length and

FiG. 1.

any angle. (Fig. 2.) Thus straight splints may be madefrom 8 in. to 4 ft. 8 in. in length, internal or external

angular splints with fenestra for the condyle at any angle,obtuse, acute, or right ; Carr’s or pistol splints for wrist or

FIG. 2.

metacarpus, and finger or thumb splints. By means of twosections bent on the flat, anterior and posterior angularsplints, or leg splints with sole, plate, or foot-piece, may beconstructed with fenestra for the malleolus. The bolts andnuts are carried in a flat holder, from which they are unableto fall out. They occupy a minimum of space, and twosections can be firmly bolted together with the fingers onlyin 30 seconds or less.

FIG. 3.

The whole apparatus, in bright aseptic metal, with bolts,padding, and triangular bandage, kept together by the bucklesand bands used in their application, is contained in a neatkhaki case which can be carried in the pocket. (Fig. 3.)The splint has been constructed to my design by the

Holborn Surgical Instrument Co., Limited, 26, Thavies Inn,Holborn Circus, London, E. C.

F. THOMPSON, M.R.C.S., L.R.C.P. Lond.Sunbury-on-Thames.

F. THOMPSON, M.R.C.S., L.R.C.P. Lond.

A NOTE ON WICK DRAINS.

THE ordinary drain or " plugging " of folded gauze takesa certain period of time to make. When the gauze is at allhard or its fibre coarse, partially glazed or mercerised, as isnotably the case with some of the American gauzes, the

difficulty of folding is increased. Machine-made pluggingis expensive and the sizes to hand are not always thoserequired. It occurred to me that at this time, when largequantities of plugging are required for use with hypertonicor other treatment or for stopping a secondary haemorrhage,it would be advisable to use some form of cheap lamp wick,but the woven varieties are rather closely knit and thetwisted varieties are apt to be unmanageable with a probe.Some of the wicks sold do not absorb water.A simple solution of the problem, apart from constructing

a machine for the purpose or adapting a knitting machine,is to utilise a child’s knitting reel with which reins or " cats’tails " are made. Three pins to the reel seem to be betterthan a larger number, but if a more truly circular andtubular wick is desired a larger number may be used. Inthis case the product is either closer in texture or undulylarge.

The illustration shows three reels of convenient sizes, thedrains being 1/2 inch, 3/8 inch, and 1/4 inch in diameterrespectively. These sizes are made by employing reels ofthe following measurements (in inches) :-

Diameter of wick ...... ½ ...... 3/8 ...... ¼Size of reel-

Height............ 1 ...... 1Q ...... 1 3/4Outside diameter ... 2 ...... 12 ...... 1¼Diameter of hole ... LI- ...... ½ ...... 3/8Side of triangle ...... 1½ ...... ....... %

Size of cotton ......... 2 ...... 4 ...... 10In the above table the only important measure is the

distance between the feet of the (equilateral) triangle formedby the pins, because on this depends the size of the stitch inthe tail. The other measurements merely indicate the sizesof reels convenient to work with. Any reel large enough totake the triangle and having a hole large enough not tocompress the tail will do. Any kind of pin or tack willanswer the purpose, but a convenient thing to use is a

full-gauge, 5/8 inch, brass escutcheon pin, sold by mostironmongers.The cotton used is Alexander’s 4-thread knitting cotton

(bleached), and the sizes to correspond with reels of the above-mentioned measurements are No. 2 (thick), No. 4 (medium),and No. 10 (thin), the approximate diameters of these threadsbeing 1/8 inch, 1/16 inch, and 1/32 inch (the last one plus).This cotton is a smooth loose twist of four strands which

Page 2: A NOTE ON WICK DRAINS

398

does not tend to fray out and is lissome and absorbent. Anysoft-fibred cotton will do, but for each size there is a corre-sponding size for the sides of the triangle if a tail of theright body and tension is to be obtained-viz., one in whichthe mesh is open and the strands do not fall and clingtogether. The cost at retail price of the cotton mentionedis ls. 2d. the lib. hank for all sizes. Each hank makes :Of No 10 (thin) 130 yards of wick-time 36 hours ; of No. 4(medium), 42 yards of wick-time 9 hours ; of No. 2 (thick),22 yards of wick-time 5 hours. The thick size is cutinto lengths of 6 and 10 inches, the medium into lengths of4 and 7 inches, and the small into lengths of 3 and 6 inches.the loose clippings removed, and the ends caught up into asingle knot; or this may be done in the making. This

process adds about four hours to the total time for the above.

mentioned quantities. The thick variety is more suitable foruse as plugging than as a drain, and for drainage should beused two or more strands of the medium instead of one of thethick size.

Convalescent patients or children can readily make largequantities of these drains and thereby save a good deal ofthe nurse’s time which at’ present is taken up in foldinggauze. There are no raw edges ; the mesh is open and theabsorbing power great, partly owing to the choice ofmaterial and partly to the sizes of the stitches. The twistin the cotton produces a high degree of capillarity and theattraction between the films in the meshes is considerable.

G. H. COLT, F.R.C.S. Eng.,Assistant Surgeon, Royal Infirmary, Aberdeen.

Aberdeen.

A MONTHLY RECORD OF ATMOSPHERIC POLLUTION.

COMMITTEE FOR THE INVESTIGATION OF ATMOSPHERIC POLLUTION :

Summary of Reports for Month ending April 30th, 1915.- I I I I I

Gauge tampered with, results unreliable.Col. 4 includes all matter insoluble in water but soluble in CS2. Cot. 5 includes all combustible matter insoluble in water and in es2.

Col. 6 includes all earthy matter, fuel, ash, &c. One metric ton per sq. kilometre is equivalent to: (a) Approx. 91b. per acre; (b) 2’56 Englishtons per sq. mile; (c) one gramme per sq. metre; (d) 1/1000 millimetre.of rainfall (see Col. 3).

The analytical work involved in these returns was undertaken respectively by J. F. Liverseege, F.I.C., Birmingham; Harry Hurst,B.Sc.. F.I.C., Bolton ; F. Southerden, B.Sc., F.I.C., Exeter ; A. R. Tankard, F.I.C., Kingston-upon-Hull; W. H. Roberts, M.Sc.. F.I.C., Liver-pool ; S. A. Vasey, F.I.C.. Director, TxF LANCET Laboratory (London Meteorological Office collections) ; J. H. Coste, F.I.C. (EmbankmentGardens, Finsbury Park, Ravenscourt Park, Southwark Park, Wandsworth Common, Victoria Park collections), London: F. L. Teed. D.Sc.,Golden-lane, London, E.C. ; C. C. Duncan, F.I C.. Malvern; E. Knecht Ph.D., M.Sc.. Ancoats Hospital, Bowdon, Cheadle. Davyhulme. Fallow-field. Moss-side, Philips Park, Queen’s Park, School of Technologv. Whitefield (Manchester collections); J. T. Dunn, D.,Sc., Newcastle-on-Tyne;Samuel Urmson. Oldham ; Professor W. P. Wynne, Attercliffe Burial Ground, Hillsborough Park, Meersbrook Park, Weston Park (Sheffieldcollections); S. H. Davies, M.Sc.. York; Messrs. R. R. Tatlock and Thomson, Coat bridge : Messrs. J. W. Biggart, F.I.C.. and McCowan,Greenock; A. Scott Dodd. RSc.. F.I.C., and R. M. Clark, B.Sc., Leith and Paisley respectively. The correspondents referred to in ool.2arefor the most part public health authorities.