Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . the operator. It is equivalent toan elevation in altitude of 250 to 300 feet. The positive pressure to whichthe anesthetist is subjected is so slight as to be scarcely noticeable. THE THORAX 453 OPERATIONS ON THE LUNGS For Diseases of the Lungs see page 413. The lung may be cut with knifeor scissors, but if a large wound is to be made multiple ligatures should havebeen tied on either side to prevent bleeding. Indurated areas may be incisedwith less bleeding. Blunt
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . the operator. It is equivalent toan elevation in altitude of 250 to 300 feet. The positive pressure to whichthe anesthetist is subjected is so slight as to be scarcely noticeable. THE THORAX 453 OPERATIONS ON THE LUNGS For Diseases of the Lungs see page 413. The lung may be cut with knifeor scissors, but if a large wound is to be made multiple ligatures should havebeen tied on either side to prevent bleeding. Indurated areas may be incisedwith less bleeding. Blunt dissection or tearing may be practised for shortdistances. A bloodless incision may be made by means of the red hotcautery knife. When a lung is incised deeply enough to open large bronchi,the patient should not lie with the sound side down because of the dangerof blood running into the sound lung. Cavities are opened by enlarging anarrow incision or puncture by blunt dilatation. The patient may be placed on the ordinary operating table and the posi-tion controlled by sand-bags, or the special table of Friedrich may be used. Fig. 1125.—Special Table for Operations on the Thorax (Fig. 1125). A necessary instrument for thoracic surgery is the rib spreaderor retractor which permits wide access with a minimum of assistance andexternal wound (Fig. 1126). Exposure of the lungs for pneumotomy, pneumectomy or other operation,may be made by a simple rib resection, as described for empyema, by resect-ing two ribs through an incision placed between them, or by making a thoracicflap (Fig. 1127). Such a flap may retain the divided rib segments, or theymay be sacrificed and the flap consist only of soft tissue (see also Thoraco-plasty, page 410). In making these thoracic flaps consideration should begiven to the source of blood-supply in order to insure the best of incision running parallel with the ribs are to be preferred (Fig. n28)The division of the ribs in a flap ha
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
