Sternal Puncture

recent books on hsematological technique \!ere is often no reference to the possibility of sepsis manubnum sterni, following sternal puncture. , When sternal puncture first came into common use 0r hematological and kala-azar investigations, two ases in my wards at the Mayo Hospital, Lahore, eveIoped septic infections of the bone marrow and steomyelitis of the manubrium, leading to long and senous illnesses. 24 K6 Practice was then begun of preparing the skin hours before the puncture, as for a surgical operatW* anc^ the skin with a sharp knife, so at the sternal puncture needle does not pass through the actual skin. Wearing: of two recent cases of osteomyelitis of the anubrium, one of which led to septicaemia, has rompt,ed me to write this note. Experience shows that the greatest aseptic care is ?Ssef1tial for any type of paracentesis or puncture of ? internal organ. It is recommended that the techlcl"6 suggested above be used in all cases where a ..eedle is inserted into an internal organ, i.e. pleura. 'I"er: spleen or peritoneum, in such cases as pleural "Usion and empyema, liver abscess, and ascites. kuch procedures are too often left to the recently jj~aufied house man or the inexperienced medical nicer, without precise instructions of the essential technique.