. A new manual of surgery, civil and military. tsposterior attachment, the bleeding points having been caught carefully duringeach step of the operation so that the entire amount of blood lost will beslight. It is important that the tumor be not manipulated roughly because it seems 210 SURGERY OF THE CHEST likely that carcinomatous cells could be loosened from the substance of thegrowth if careless handling or pressure be allowed. If there still remain small portions of fat attached to the axillary structuresthey can be removed with great rapidity and perfect safety by grasping themin a piece
. A new manual of surgery, civil and military. tsposterior attachment, the bleeding points having been caught carefully duringeach step of the operation so that the entire amount of blood lost will beslight. It is important that the tumor be not manipulated roughly because it seems 210 SURGERY OF THE CHEST likely that carcinomatous cells could be loosened from the substance of thegrowth if careless handling or pressure be allowed. If there still remain small portions of fat attached to the axillary structuresthey can be removed with great rapidity and perfect safety by grasping themin a piece of moist gauze held in the hand and drawing this gauze over thesestructures, permitting them to slip through the grasp of the hand holding thegauze. In this manner these small portions of fat containing minute lymphaticglands may be removed more perfectly and with much greater ease and rapid-ity than by actual dissection. All the bleeding vessels that have been caught,from which bleeding has not been stopped permanently by the pressure of the. Pectoralis Muscle Severed from Beneath, and Perforating Branch of the Internal Mammary Caught -with Forceps. (Jabez Jackson.) hemostatic forceps, should be ligated. We make use of fine catgut for thispurpose. For a number of years we have followed the plan of preserving the distalend of the pectoralis minor muscle and cutting away only the proximal halfof it for the purpose of covering the axillary structures. After thoroughlyremoving all the fat and lymph nodes in the axilla, the cut end of the distalportion of the pectoralis minor muscle is sutured to the intercostal musclesso that this remnant of the pectoralis minor muscle protects these structures. The area exposed is so enormous that a certain amount of serous dischargemust be expected, and consequently we believe it is wise to insert one or twomoderate-sized drainage tubes through an opening in the posterior flap, asshown in plate. The wound is then united by means of interrupted t
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
