File:A manual of modern surgery - an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners (1899) (14779529821).jpg

Identifier: manualofmodernsu1899robe (find matches)
Title: A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners
Year: 1899 (1890s)
Authors: Roberts, John B. (John Bingham), 1852-1924
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ugh to overlap the borders ofthe wound. This is in turn covered with a voluminous dressing ofdry sublimate gauze. The rubber tissue keeps the blood clot moist,the dry antiseptic dressing absorbs all leakage of blood and serum. This method of Schede is only possible when the entire mass orall the masses of necrotic bone are removed, when all the pus infectedmembrane and granulation tissue lining the irregular tracks and cavi-ties have been scraped away with absolute certainty, and when thecavities so made have been thoroughly sterilized by antiseptic solu-tions and wiped clean with aseptic sponges. Gerster recommends sub-limate lotion (1:500) to be used. This is subsequently washedaway by a weaker sublimate solution, so that toxic effects may not fol-low the retention in the wound of small quantities of the strong lotion.Filling the cavity with very hot water or oil has been suggested as ameans of sterilizing its walls. The fluid is then mopped out before thewound is dressed. Fig. 129.
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Schedes method. Diagram showing relations of organizing blood clot. (Gerster.) If it is impossible to remove a sequestrum, excision of a portion ofthe bone or of the joint may be demanded. When the destruction ofbone has been very great or the patient is already sinking from ex-haustion, due to long-continued bone disease, amputation may be themost judicious treatment. CARIES OR ULCERATION OF BONE. Pathology.—The disintegration or erosion of bone, called caries, isa process similar to ulceration in soft tissues, for the destroyed struc-ture is removed in small particles, usually in a more or less liquefied CARIES OF BONE. 337 form. In this circumstance caries differs from necrosis, in which thedevitalized portion of bone is separated from the surroundiug livingosseous tissue in masses. Caries, therefore, corresponds with ulcera-tion of soft tissues ; necrosis with gangrene. Caries is not a disease, butthe result of a bone disease; usually tuberculosis, sometimes syphilis.As there is

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