Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    injured glands in tlie burnt skin, may now occur, and is? said to most frequently begin about the tenth day._ 3rd St^GH.—Suppuration and exhaustion.—Uuxmg this stao-e, which sets in on the separation of the_ sloughs, thei-e is still a danger of the patient succumbing to in- flammation of the viscera, especially the thoracic ; or he may be worn out by hectic and exhaustion from long- continued suppuration. He is also exposed to the risks of secondary htemorrhage on the separation of the slougli^, and to blood-poisoning from the absorption of septic pro- ducts, unless the greatest care is exercised to prevent the decomposition of the discharges. On cicatrization occnr- rino- horrible deformity may ensue from the contraction of the newly-formed fibrous tissue m the scars The Treatment must be both local and constitutional. Local treatment.-The clothes should be removed with the greatest care, so as not to tear oft the cuticle; hnz undue exposure should be avoided. In buims of the fir.t and second degree, the part must be protected fi-om the air and change of temperature by smearing it with vaseline and wrapping it in cotton-wool, the bhsters bein- pricked to relieve tension and to let out the serum. The cuticle, however, should not be removed as it serves as the best protective. In burns of the third degree, the pai-ts may also be protected by cotton-woo trll he sfouo-hs begin to separate. Decomposition of the dis- chS-ges should then be prevented as much as possible by Shf antiseptic dressings. Thus, tl^e -irtaco may be ■dustedwith iodoform; or eucalyptus oil. boracic lotion, and the like may be a]n)lied. Some surgeons put on a charcoa or even a inseed-meal poultice. . Carbohc -^cid shou d not be used, as not ouly is it too irritating, but there s SaLerof i s being absorbed when the burn is very ex- tensh-e. When the sloughs have separated, and gram - latioii sets in, the wound may be treated as described under Smple Seer redundant granulations bouig repressed by ■iln/p of slvcr Skin-graftimj is often useful m the Wh c o'n-ee oi b mis. The fourth and iifth. degrees ?e diVfe san,e treatment as the third, but durmg cica- S t on contraction must be as far as possible prevented tv the use of elastic tension, extension-appar.atus Slints?&c. In the sixth degree, .ampu ation i a bmb Sected will probably sooner or lat.n- bo called for. lt^JMLnnreat.ne]>t.-U the shock -vere^ stou- Pints in the form of brandy or ammonia should be given
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