Licence: In copyright
Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![SECTION II. General Pathology of Injuries, wounds. Wounds are divided into two great classes, the open and the subcutaneous. Open wounds.—A wound has been defined as “a solution of continuity in any part of the body, suddenly made by anything that cuts or tears, with division of the skin.” Here our attention will be confined to the general pathology and treatment of wounds of the soft tissues. Wounds of special tissues, as bone, muscle, blood-vessels, nerves. Ac., will be further referred to under those heads. The process of repair in open wounds of the soft tissues differs according as the wound is incised, lacerated, contused, or punc- tured, and according as it is, or is not, kept aseptic, properly drained, and protected from infective processes. The healing process will, moreover, be influenced by the patient’s state of health previous to the wound, and the hygienic conditions under which he is subsequently placed. Let us first take a general view of the ])rocess of repair as it occurs in a simple incised wound in a healthy subject. Immediately the wound is inflicted there will be free haemorrhage varying in amount according to the vascu- larity of the part, probably a spouting of blood in jets from a few larger arteries, and a more or less general oozing from the smaller vessels and capillaries. The haemorrhage from the larger artei'ies having been arrested, and that from the smaller having ceased spontaneously, the wound, if accurately closed and kept aseptic and at rest with its surfaces in contact, will unite without suppura- tion by a process of simple or adhesive inflammation. Thus, the edges of the wound for the first day or two may present a very faint blush of redness extending for a few lines to perhaps in a large wound half an inch or so beyond the incision; whilst they may be slightly swelled, a little hotter than natural, and tender on pressure, but quite devoid of pain. The redness, swelling and heat, however, may be so slight as to be almost imperceptible, or indeed may be said in some instances not to occur. If an attempt were now made to draw the edges apart, they would be found adherent to each other, and a few days later firmly united. All trace of redness and swelling about the edges will by this time have disappeared, a red streak only remaining to mark the line of](https://iiif.wellcomecollection.org/image/b21979273_0108.jp2/full/800%2C/0/default.jpg)
