. Postoperative treatment; an epitome of the general management of postoperative care and treatment of surgical cases as practised by prominent American and European surgeons. bed. The methodwhich Kocher now employs, and which is described in a recent (1903)edition of his Text-Book of Operative Surgery, is a modification andextension of the Sedillot-Syme operation, in which the lower lip isdivided vertically and the symphysis menti is sawed through, permittingfree access to the floor of the mouth. Kocher divides the soft tissuebackward to the hyoid bone. All vessels are ligated as they are sev
. Postoperative treatment; an epitome of the general management of postoperative care and treatment of surgical cases as practised by prominent American and European surgeons. bed. The methodwhich Kocher now employs, and which is described in a recent (1903)edition of his Text-Book of Operative Surgery, is a modification andextension of the Sedillot-Syme operation, in which the lower lip isdivided vertically and the symphysis menti is sawed through, permittingfree access to the floor of the mouth. Kocher divides the soft tissuebackward to the hyoid bone. All vessels are ligated as they are severedduring operation. The wound is closed by wiring the divided bone andsuturing the soft parts anteriorly, but an important point is that thorough OPERATIONS. 159 drainage is secured through the floor of the mouth, the gauze beingcarried through the skin-incision near the hyoid bone. The method ofKocher has the following advantages: the postoperative hemorrhageis very slight or more easily controlled, the secretions of the wound aredrained away much more satisfactorily, and preservation of the tissuesof deglutition along with their nerves, by which a better functional. Fig. 40.—Anatomic Relations of the Parts Involved in Kochers PresentOperation for Removal of the Tongue by Median Division of the LowerJaw.—{Kocher, American Text-Book of Surgery) a, Line of division of the mucous membrane; b, lingual nerve; c, lingual vein; d,lingual artery; e, hyoglossus muscle; /, hypoglossal nerve; g, tongue; h, right geniohyo-glossus muscle; i, left geniohyoglossus muscle; k, geniohyoid muscle. result is obtained than by any other method. This preservation of thepowders of deglutition is of the greatest importance in preventing secon-dary pneumonia, the great danger which threatens the patient. Method of After-treatment by Sir Frederick Treves.—The patientmay be allowed up on the third or fourth day, and in the majority ofthe cases I have treated at the London Hospital the patient has
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