Identifier: postoperativetr00mors (find matches)
Title: Postoperative treatment; an epitome of the general management of postoperative care and treatment of surgical cases as practised by prominent American and European surgeons
Year: 1907 (1900s)
Authors: Morse, Nathan Clark. (from old catalog)
Subjects: Operations, Surgical. (from old catalog)
Publisher: Philadelphia, P. Blakiston's son & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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s. Some sup-puration may take place between the approximated surfaces of perios-teum, and some is sure to take place between the soft tissue edges.Consequently it is advisable to leave the stitches in the periosteum as farapart as is possible with accurate approximation of the edges. Theedges of the soft tissue may be closely approximated, but provision fordrainage should be made by very small gauze wicks or catgut drains. The operation produces moderate depression, not so severe as anamputation. In spite of all precautions there is likely to be someevidence of septic absorption, which makes its appearance on the secondor third day, but usually disappearing within a week. In two casesthe postoperative infection was sufficient to cause mild delirium forseveral days. The wound may heal by first intention over the greater portion, butsome redness and slight sloughing of the edges may appear. In one OSTEOMYELITIS. 437 case this sloughing was sufficient to cause considerable gaping both of
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Fig. 150.—Marked Induration of Tibia.—(Nichols.)soft tissue and periosteum. Sinuses often develop for a time, but have 438 POSTOPERATIVE TREATMENT. always ultimately disappeared. They usually appear near the epiphy-sis, or at the junction of periosteum and shaft. As has been said, some-times a slight amount of cureting may be necessary before permanentclosure takes place. It is desirable to prevent retention of infectedmaterial because of danger to the epiphysis and ultimate infection ofthe joint. The first dressing should be changed by the third day. After thattime, dressings should be replaced sufficiently often to absorb any dis-charge; a wet dressing may be necessary for the first ten days. Marked induration along the line of the bone is frequently felt by thethird week (Fig. 150). From that time on the bone gradually increasesin density and size. The new shaft at first and for some months has nomarrow canal, but is composed entirely of trabecular from periosteal bonewith gran

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