File:Preparatory and after treatment in operative cases (1910) (14803345163).jpg

Identifier: preparatoryafter00haub (find matches)
Title: Preparatory and after treatment in operative cases
Year: 1910 (1910s)
Authors: Haubold, Herman A. (Herman Arthur), 1867-1931
Subjects: Preoperative Care Postoperative Care
Publisher: New York and London, D. Appleton and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ame problem with respect toafter-treatment as obtains in the conditions just discussed. As arule, the wound is entirely closed without drainage. It is, how-ever, wise to permit a small drain to remain in the inferior angleof the wound for several days after the operation, in order to giveopportunity for the discharge of blood, the outcome of a recur-rence of oozing, which is not, in all cases, apparent at the timeof the operation. Tor the purpose a few strands of silk-wormgut may be used (Fig. 147), which are removed on the third dayfollowing the operation. When drainage is omitted, the tunica VARICOCELE 581 becomes distended with blood, which at times causes the formationof a large tumor, and an infiltration of the subcutaneous tissueupon the abdomen over the penis and down the thigh. When thebleeding persists, the distention extends into the inguinal canal,making pressure on the cord and testicle which gives rise to con-siderable pain. Fig. 365 shows a case of this sort. The patient
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Fig. 365.—Infiltration of Tunica, Scrotum and Penis with Blood followingOperation for Relief of Varicocele. had an unusually extensive venous dilatation, the operative pro-cedure involving considerable trauma to the adjacent tissues inorder to accomplish the purpose. The wound was reopened, theclots removed, and drainage established. The case illustrated thelessened coagulability of the blood, as the patient had just re-covered from an attack of jaundice due to gastroduodonitis.There was a considerable amount of oozing for some days afterthe operation, and convalescence was exceedingly protracted. Reopening of the wound and removal of the blood should notbe postponed too long, as in some instances pressure, necrosis, andsloughing of the testicle have occurred as the outcome of delay. After the wound has been reopened, the local conditions areexceedingly favorable to the invasion of infection. Great careshould be exercised to obviate this occurrence. The contiguity ofthe wound to the

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