Surgery.

Date:: [1913]

Credit: Surgery. Source: Wellcome Collection.

13/412 page 5

$streptococcal serum ; (/) sulphanilamide preparations, e.g. prontosil, M.&B. G93, etc., may be given by mouth or by intramuscular or intravenous injection in doses up to gm. 1 every four hours ; (g) blood transfusion is of value in the later stages but immuno-transfusion has proved disappoint- ing. Local measures.—Complete removal or adequate drainage of the primary focus should be carried out. Describe the Treatment of Pyaemia. Remove, if possible, the primary septic focus, and in the case of the lateral sinus, in addition, ligate the internal jugular vein on the cardiac side of the thrombosis. Second- ary abscesses, when accessible, are opened and drained as they occur. Bier’s bandage is very useful when dealing with septic compound fractures. In cases not yielding to these measures, amputation of the limb may be necessary. The general treatment for septicaemia is carried out. Give the Clinical Features of Cellulitis. Cellulitis is an infection of the subcutaneous tissues and usually results from a small wound, the infecting organism in most cases being the streptococcus. The organisms spread in the loose tissue and the process rapidly extends to a considerable distance from the wound. Infiltration of the tissue planes causes greatly increased tension with impairment of the blood supply and extensive sloughing and necrosis may occur. The affected area is swollen, dusky red in colour, hot and tender, and in the early stages feels brawny, but later softening occurs, producing the characteristic boggy feeling. Lymphangitis and lymphadenitis are frequently present and the general symptoms are those of septicaemia. Tf untreated, the pus burrows widely, blisters containing sero- pus form on the skin which eventually gives way. What is the Treatment ? The general treatment of septicaemia is employed. Local therapy comprises complete rest of t he part, hyperaemia. by$

Surgery.

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