Manual of Surgery - Volume First: General Surgery. Sixth Edition. by Alexis Thomson;Alexander Miles
page 87 of 798 (10%)
page 87 of 798 (10%)
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His temperature rises to 100° or 101° F., and the pulse quickens to 100
or 110. On exposing the wound it is found that the parts for some distance around are red, glazed, and Ådematous. The discoloration and swelling are most intense in the immediate vicinity of the wound, the edges of which are everted and moist. Any stitches that may have been introduced are tight, and the deep ones may be cutting into the tissues. There is heat, and a constant burning or throbbing pain, which is increased by pressure. If the stitches be cut, pus escapes, the wound gapes, and its surfaces are found to be inflamed and covered with pus. The open method is the only safe means of treating such wounds. The infected surface may be sponged over with pure carbolic acid, the excess of which is washed off with absolute alcohol, and the wound either drained by tubes or packed with iodoform gauze. The practice of scraping such surfaces with the sharp spoon, squeezing or even of washing them out with antiseptic lotions, is attended with the risk of further diffusing the organisms in the tissue, and is only to be employed under exceptional circumstances. Continuous irrigation of infected wounds or their immersion in antiseptic baths is sometimes useful. The free opening up of the wound is almost immediately followed by a fall in the temperature. The surrounding inflammation subsides, the discharge of pus lessens, and healing takes place by the formation of granulation tissue--the so-called "healing by second intention." Wound infection may take place from _catgut_ which has not been efficiently prepared. The local and general reactions may be slight, and, as a rule, do not appear for seven or eight days after the operation, and, it may be, not till after the skin edges have united. |
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