An _unhealthy or devitalised condition of the patient's tissues_ also
hinders the reparative process. Bruised or lacerated skin heals less
kindly than skin cut with a smooth, sharp instrument; and persistent
venous congestion of a part, such as occurs, for example, in the leg
when the veins are varicose, by preventing the access of healthy blood,
tends to delay the healing of open wounds. The existence of grave
constitutional disease, such as Bright's disease, diabetes, syphilis,
scurvy, or alcoholism, also impedes healing.

Infection by disease-producing micro-organisms or _pathogenic bacteria_
is, however, the most potent factor in disturbing the natural process of
repair in wounds.


SURGICAL BACTERIOLOGY

The influence of micro-organisms in the causation of disease, and the
rôle played by them in interfering with the natural process of repair,
are so important that the science of applied bacteriology has now come
to dominate every department of surgery, and it is from the standpoint
of bacteriology that nearly all surgical questions have to be
considered.

The term _sepsis_ as now used in clinical surgery no longer retains its
original meaning as synonymous with "putrefaction," but is employed to
denote all conditions in which bacterial infection has taken place, and
more particularly those in which pyogenic bacteria are present. In the
same way the term _aseptic_ conveys the idea of freedom from all forms
of bacteria, putrefactive or otherwise; and the term _antiseptic_ is