Fistula of the withers and poll-evil . tachedin situ. The fourth step is the insertion of the drain-age tube. This is done with the drainage tubeinserter. (Fig. 3.) Armed with the tube the point of the inserteris placed at the bottom of the cavity and thenpushed out laterally in the downward directionthrough the splenius and serratus cervicis mus-cles to the surface. The skin must be incisedas the j)oint of the inserter bulges it out as itspoint is not sharp enough to penetrate it un-assisted by an incision. When inserted on theone side the inserter is passed into the otherend of the tube and
Fistula of the withers and poll-evil . tachedin situ. The fourth step is the insertion of the drain-age tube. This is done with the drainage tubeinserter. (Fig. 3.) Armed with the tube the point of the inserteris placed at the bottom of the cavity and thenpushed out laterally in the downward directionthrough the splenius and serratus cervicis mus-cles to the surface. The skin must be incisedas the j)oint of the inserter bulges it out as itspoint is not sharp enough to penetrate it un-assisted by an incision. When inserted on theone side the inserter is passed into the otherend of the tube and pushed through the sameplace on the opposite side. This places thetube across the bottom of the cavity and out toeach side of the neck. (Fig. 4.) When the operation is prolonged for anycause and the blood loss has been great, wepostpone the insertion of the tube until the TREATMENT second day, at which time it is inserted in thestanding position. It is advisable in passing tubes through thisthick musculature to keep the neck in a nor-. Inserting the Drainage Tube. mal position. Otherwise the tube will be in astrained position. The fifth step is that of packing and sutur-ing the cavity. For this we use sterilized anti-septic oakum. We prepare the oakum already 84 FISTULA AND POLL-EVIL arranged in wads of different sizes so that itcan be packed into the recesses piece by piecewhere it will press directly upon the bleedingvessels and thus arrest the hemorrhage at indifference is displayed in this connection,the bleeding may force its way between the
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