Submucous excision of deviations and spurs of the nasal septum : with a report of the first 30 operations / by StClair Thomson M.D., F.R.C.P., F.R.C.S., physician for diseases of the throat in King's College Hospital; surgeon for diseases of the nose, throat, and ear, in the Seamen's Hospital, Greenwich.

  • Thomson, St. Clair, 1859-1943
Date:
1906
Catalogue details

Licence: In copyright

Credit: Submucous excision of deviations and spurs of the nasal septum : with a report of the first 30 operations / by StClair Thomson M.D., F.R.C.P., F.R.C.S., physician for diseases of the throat in King's College Hospital; surgeon for diseases of the nose, throat, and ear, in the Seamen's Hospital, Greenwich. Source: Wellcome Collection.

    19/54 page 15
    with sterile gauze, and care is taken that no chips of bone or cartilage are left in between the two flaccid mucosae (Fig. 11). Stitching the Wound. The original wound is now closed with one or two stitches. A very small Trelat needle is armed with finest cleft-palate silk (No. 000), and while an assistant holds the nostril open with a retractor the edge of the posterior flap is seized with a small pair of dissecting or toothed forceps, and then traversed with the threaded needle from behind forwards. The needle is carried in the same way through the anterior edge of the wound, one end of the silk is pulled out with a fine hook, the needle is then withdrawn, carrying the other end, and the stitch is tied. Care, of course, is taken that the edges of the wound are properly affronted. One or two stitches may be required. The Dressing. The formerly obstructed nostril is now lightly packed with pencils of dry sterilised cotton-wool, well smeared with simple vaseline. One or two plugs in the opposite side may be introduced. The nose should not be plugged tightly, our object being simply to keep the two mucous membranes in apposition. In some cases I have done without any plug (Nos. 3, 4, 9, 10, 11, 14). After-Treatment. The patient rests quietly for the remainder of the day, sips some iced drink, and keeps an iced cloth across the bridge of the nose. A little blood-stained oozing is best met by ice-water ablution to the face and neck. I have never had any secondary bleeding requiring attention. Cotton-wool, dipped in cold boracic lotion, is used for wiping out the blood which dries in the vibrissse and causes discomfort to the patient.
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