. Manual of operative surgery. together and healing by first intention sought. Several differentmethods of attacking the bone with a view to obliterating the cavity will bedescribed later. While working on the bone be careful to avoid fracturing that portion ofthe involucrum which is to be retained and on which the continuity of structuredepends. Step 3.—With the curette, aided if necessary by the gouge, remove alldiseased granulation tissue and bone from the inside of the involucrum andfrom any existing fistulae. Swab the cavity with Harringtons solution or withliquid carbolic acid (95 per ce
. Manual of operative surgery. together and healing by first intention sought. Several differentmethods of attacking the bone with a view to obliterating the cavity will bedescribed later. While working on the bone be careful to avoid fracturing that portion ofthe involucrum which is to be retained and on which the continuity of structuredepends. Step 3.—With the curette, aided if necessary by the gouge, remove alldiseased granulation tissue and bone from the inside of the involucrum andfrom any existing fistulae. Swab the cavity with Harringtons solution or withliquid carbolic acid (95 per cent.) subsequently swabbing with alcohol. Ochsnerfollows this by applying tincture of iodine. If there is any doubt as to the com-plete removal of all infected tissue, pack the cavity with iodoform gauze andif the wound is found aseptic, after a few days close it with sutures. TheCarrol-Dakin treatment may be used. If it is believed that all disease hasbeen removed the wound may be closed at once, any non-obliterated cavities. Fig. 1148.—Sequestrotomy. The bone is divided at A and B and the(Shaded area 950 OSTEOMYELITIS being drained, or the cavity may be filled with Mosetig-Moorhof iodoformand wax plug. The author has had very satisfactory result from filling thecavity with a powder consisting of iodoform i, boracic acid (in crystals) when the cavity was not above suspicion in regard to cleanliness rapidhealing has ensued. After dressings are applied fix the limb in a splint. Re-generation of the bone is usually rapid. Methods of Obliterating the Bone Cavity after Sequestrotomy.—It isassumed that the sequestrum and all diseased tissue have been completelyremoved, that the cavity has been disinfected and packed with gauze, that theskin around the wound has been prepared as if for a new aseptic operation,that the surgeon and assistants have prepared themselves and the instrumentsas if for a fresh operation. I. Schedes Aseptic Blood-clot.—Remove the pack o
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