Book Description

Excerpt from A Treatise on Regional Surgery, Vol. 3 It may be wise to delay operative measures and carry out only those details which are immediately necessary. This is particularly true in accidents from machinery, explosions, or crushing of any sort where grease or foreign material is ground into the tissues. In these doubt ful cases the first treatment should be limited to the cleansing Of the wound and its surrounding skin, the ligation of bleeding vessels, and the removal of foreign material or torn and soiled tissues whose circulation has been evidently destroyed. The skin may be freed of grease or dirt by means of gasoline, turpentine or ether. The treatment of such wounds and the surrounding skin solely with iodine for cleansing and dressing IS rapidly gaining in favor. Another popular method is the irrigation of the wound with sterile water and the application of a moist, mildly antiseptic dressing. Gauze saturated with a weak solution of bichloride of mercury (i - sooo) may be used. Carbolic acid solutions Should be avoided as a continued application, and bi chloride should not be used after iodine because of the irritation produced. Pockets and cavities are drained with wicks of gauze covered with rubber tissue. In no case should sutures be tightly placed, and it is better to Close the skin loosely with few stitches far apart. Conservatism is the rule at first until the viability of the tissues is determined, and the temptation to accomplish classical Operations must be strictly avoided. Gangrene or extensive infection may demand amputation. Avulsion of the arm is accompanied by great shock and calls for most conservative treatment. Bleeding is often Slight because of the curling up of the intima Of the torn artery; nevertheless the vessel Should be caught and ligated. Projecting nerves should be injected with cocain or novocain and then. Divided high up so as to avoid the resulting scar; the protruding ends of bone should be excised. The skin is only loosely sutured and drainage provided. Gunshot injuries of the arm demand immediate operation only for the control of severe hemorrhage or the removal of superficial splinters. Otherwise the small wound of entrance and the large one of exit may both be treated conservatively and repair of injured deeper structures made under favorable conditions. If infection occurs, drainage and Open treatment will be necessary as in any infected wound. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.