A system of practical surgery / by William Fergusson.

  • William Fergusson
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

    78/878 (page 54)
    Fig. 50. to be treated according to the methods afterwards recommended for these processes. When immediate union is not expected, the best plan is to foment and poultice to encourage suppuration; for, as is after- wards stated in the chapter on effusion of pus, I believe that this event will, in some degree, alleviate the patient’s sufferings. Possibly there may be such a degree of inflammation as to render leeches advisable : sometimes it may be of a gangrenous character: often it is erysipela- tous—as in severe punctured wounds, or those received in dissections, when high action ensues; but the directions given in future chapters, for the treatment of these different conditions will save reference to them in this place. When bleeding from a wound has been staunched, and all extra- neous material has been removed, its edges are generally brought in contact, in hopes that they will speedily unite. Various means are resorted to for keeping the cut surfaces in apposition, and these cha- racterise the different kinds of sutures.^ A combination of stitching and bandaging is applied, in almost all instances where a wound is of such magnitude that its edges gape. . The interrupted suture (fig. 50) is in most frequent use. It is formed by passing a needle and thread, such as are represented on a preceding page (fig. 46), through the skin and subcutaneous cellular texture from without in- wards on the one side, and from within out- wards on the other, at about the fourth of an inch distant from each margin, and fastening the ends of the thread with sufficient tightness to prevent the surfaces from separating. It has been recommended that the knot should be kept at one side, instead of being left exactly over the wound, as is the usual custom. The stitches are proportioned in number to the ex- tent of the wound; they are commonly placed about an inch from each other: where the dis- tance is greater, the parts may be supported by a few straps of adhesive plaster, placed between each stitch, thus (fig. 51), or as represented in the next cut (fig. 52), where it will be observed the strap is in one piece with open spaces in it to permit the application of lotions or oint- ments, or the free discharge of matter; and, over all, it is usual to apply a few turns of a roller, which gives a more uniform support to the whole parts, and thus prevents any dragging on the stitches, from a tendencv of the edges of the wound to fall asunder. In a large wound a stump, for example, the roller can seldom be d.spensed some object to stitches in the dressing of wounds, on the ground of the additional pain and irritation they occasion; but I am firmly co