A reference handbook of the medical sciences, embracing the entire range of scientific and practical medicine and allied science . OK OF THE MEDICAL SCIENCES blunt curettage. By all means do not employ asharp curette. The long Volkmann spoon, forexample, by making innumerable fresh woundsupon the endosteum would invite septic the writer employs what he has termedpistonage. A gauze sponge of proper size is firmly rolled Tipso as to make a piston of such a diameter that it canbe with moderate ease drawn again and again, up anddown, the length of the canal—the marrow comingfree
A reference handbook of the medical sciences, embracing the entire range of scientific and practical medicine and allied science . OK OF THE MEDICAL SCIENCES blunt curettage. By all means do not employ asharp curette. The long Volkmann spoon, forexample, by making innumerable fresh woundsupon the endosteum would invite septic the writer employs what he has termedpistonage. A gauze sponge of proper size is firmly rolled Tipso as to make a piston of such a diameter that it canbe with moderate ease drawn again and again, up anddown, the length of the canal—the marrow comingfreely forth at the two openings. This piston isheld rolled in shape by a stout line, like fisMine, whichis looped around it at about four equal inter\-als: andthe line should extend for convenience a couple offeet beyond either end of the piston. (Fig. 849.)To introduce tliis instrument we must first pass throughthe marrow, in at one end and out at the other, a stoutsoft wire, such as silver or copper, with a tiny loop atone end—the end first introduced—to avoid its pierc-ing the endosteum. Once through the canal and Fig. b49.—Gauze Piston for Cleaning Out the Central Canal inOsteomyelitis. the fishline is attached to the wire loop, and the wireis withdrawn, bringing the line with it. Now it is asimple matter, if the bony entrance to the canal ischiseled smooth and a little beveled, to introduceby traction the piston, and proceed to clear away allmarrow, whether obviously diseased or apparentlysound. The piston may well be wet, before its final removal,with official, seven per cent., tincture of iodine, and bypistonage, this is spread over the lining of the canal. If bleeding continues to annoy, which has notbeen the case save in one thus far, it is con-trolled bj a piston charged with tincture of iodine;or stopping the lower opening with a firmly-heldplug made of a rubber glove or of cotton batting, andby a glass syringe filling the canal with water brough
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Keywords: ., bookauthorbuckalbe, bookcentury1900, bookdecade1910, bookyear1913
