The surgical assistant, a manual for students, practitioners, hospital internes and nurses . ly of availablehemostats. When the breast has been removed, hot padsare usually laid upon the exposed area. Before the wound isclosed, the patient is to be turned slightly towards the soundside in order that a short drainage tube may be inserted,with dressing forceps, into an opening to be made in the post-axillary line. The tension sutures usually needed vary with the tastesof different operators. While they are being tied, the flapsshould be brought together with the flats of the assistantsfingers. C
The surgical assistant, a manual for students, practitioners, hospital internes and nurses . ly of availablehemostats. When the breast has been removed, hot padsare usually laid upon the exposed area. Before the wound isclosed, the patient is to be turned slightly towards the soundside in order that a short drainage tube may be inserted,with dressing forceps, into an opening to be made in the post-axillary line. The tension sutures usually needed vary with the tastesof different operators. While they are being tied, the flapsshould be brought together with the flats of the assistantsfingers. Catgut or silk sutures (usually continuous) are thento be passed to the operator for closing the wound. To facili-tate the application of the dressing the patient is drawn wellout beyond the table, the head and shoulders being supported Breast Amputation. 161 by assistants, one of whom should hold in place the tube andgauze compress applied posteriorly. The dressing- should bein the form of large pads of gauze, supplemented by flatpads of absorbent cotton over the shoulder and neck and in. Fig. 63. Application of dressing after breast operation. the axilla. The bandages should not be narrower than fourinches, nor wider than six. Several turns are first to be madeabout the chest, and then the arm is to be included as far asthe elbow. Empyema Thoracis. Diagnostic Aspiration. Unless thepus collection is presumed to be localized elsewhere the base 18S The Surgical AssisxANt. of the chest posteriorly should be disinfected. The patientis to be sat upright, as a rule, supported by an assistantshands. Small children may be held against the chest of theassistant and facing over his left shoulder, in the manner de-scribed on page 39. Before handing them to the surgeon, the syringe andneedle should be carefully tested. If the pus is not to be im-mediately evacuated, the site of puncture may be coveredwith collodion (see page 308), or with a pledget of gauzefastened by means of adhesive pla
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