quality:corruption
Improved dressing

On 19 May 1866, the first patient to use the improved method was presented at Lister's accident ward with a compound fracture with extensive swelling and bruising. The patient was John Hainy, a 21-year-old casting moulder in an iron foundry, who was supervising a crane when a chain broke and a metal box, containing a sand mould weighing 12 hundredweight or 1,344 pounds (609.6 kg), fell from a height of four feet and landed obliquely on his left leg. Both of the leg bones were broken and a wound measuring 1.5 by 0.75 inches (38 by 19 mm) had bled profusely into the muscles and tissue of the leg. A secondary complication had occurred when air bubbles had mixed with the blood when the man was moved to the hospital. In such a case, the normal treatment would be amputation, but Lister decided to treat the wound with phenol. He squeezed the leg to remove as much air and blood as possible. Then he placed a piece of lint soaked in carbolic acid on the wound, covered by tin foil. A bloody crust formed over the wound, consisting of a scab that was free of bacteria. Lister saw for the first time how the scab was gradually converted into living tissue, even when new carbolic acid was being applied - something that was entirely new. Unfortunately Hainy developed bed sores that became gangrenous and these were treated with nitric acid to remove the necrotic flesh and carbolic acid to sterilize the wound. Hainy survived the injury. On 27 May, Lister wrote to his father expressing intense satisfaction, stating "I tried the application of carbolic acid to the wound, to prevent decomposition of the blood and to prevent the fearful mischief of suppuration. It is now eight days since the accident and patient has been going exactly as though the fracture were a simple one." Two weeks later another letter followed, reporting "The great swelling has almost entirely subsided, and the limb is becoming firm". On 7 August 1866, Hainy was released from hospital.

Lister continued to refine the dressing and perfect the antiseptic treatment. He would often spend long nights experimenting in his home laboratory. He searched for a material that could be placed over the wound and under the carbolic acid, that would serve to protect the wound from the irritating effects of the acid and stop the ingress of microbes but enable bodily secretions to escape. He eventually settled on the use of oiled silk, that was sold under the "Green oiled silk protective" brand. The silk surface was painted with one part dextrin, two parts of powdered starch and 16 parts of watery acid in a 20-1 water-acid solution, to ensure a thorough wetting. The sterile silk dressing was an effective barrier between the acid and the tissue. He described the new treatment as "An antiseptic to exclude putrefaction with a protective to exclude the atmosphere will by their joint action, keep the wound from abnormal stimulus".