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 . ch the sequestrum has been taken be made perfectly aseptic by theremoval of every particle of diseased bone, diseased granulations, anddischarge. Herein lie the difficulty and frequent failure of the osteo-plastic operations deserve further trial in cases in whichthe bone has been extensively destroyed. The methods of performing sequestrotomy, adopted before the adventof modern antiseptic surgery, gave good results
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 . ch the sequestrum has been taken be made perfectly aseptic by theremoval of every particle of diseased bone, diseased granulations, anddischarge. Herein lie the difficulty and frequent failure of the osteo-plastic operations deserve further trial in cases in whichthe bone has been extensively destroyed. The methods of performing sequestrotomy, adopted before the adventof modern antiseptic surgery, gave good results ; though the healing ofthe remaining wound was very prolonged. It was always the seat ofprotracted suppuration. Septic complications were, however, uncom-mon ; because the dense inflammatory infiltration of the surrounding os-seous and other tissues rendered septic absorption difficult, and the openwound with rigid bony walls made drainage thorough and perfect. Antiseptic surgery has much shortened the process of healing bymaking possible the implantation of cellulo-cutaneous flaps and theorganization and ossification of aseptic blood clots. Fig. 127. Fig. Neubers method. Top of involucrum removed, skin flaps Implantation of cutaneous edges intoturned into the bottom of the bone cavity. (Geestee.) the defect by transfixing catgut suture. (Geestee.) Implantation of cellulo-cutaneous flaps may be done, in order tocover the fresh surface of living bone, left after cutting away all dis-eased bony structure, and thereby obtain primary union between thebone and the turned in cutaneous flaps. This leaves little or no bonysurface to heal by granulation and hastens cicatrization; though, ofcourse, a defect is left in the contour of the part. This defect wouldalso occur, even if the process of implantation was not adopted. Theturned in flaps are held in position by sterilized nails driven throughthe flap and into the bone, and by sutures passed through the skin atthe edges of the c
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