Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . the cavity leads upward, as is usually the case, an incision iscarried upward, the soft parts retracted, and ribs resected so far as is neces-sary to remove the rigid covering of the cavity. An incision is then madein the upper part of the wound, exposing the lung. The thickened depositis stripped from the lung 5 or 7 cm. (2 or 3 inches), and the patient allowedto cough. It will then be seen how much the lung is going to expand. Thewound should be closed with drai
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . the cavity leads upward, as is usually the case, an incision iscarried upward, the soft parts retracted, and ribs resected so far as is neces-sary to remove the rigid covering of the cavity. An incision is then madein the upper part of the wound, exposing the lung. The thickened depositis stripped from the lung 5 or 7 cm. (2 or 3 inches), and the patient allowedto cough. It will then be seen how much the lung is going to expand. Thewound should be closed with drainage. Muscle implantation accomplishes filling the cavity and may be combinedwith the principles of the operations to induce collapse of part of the chestwall and expansion of the lung. A curved incision which outlines the base ofthe cavity is made, as in the operation of Schede. It represents only thelower part of the U. To this S. Robinson added a vertical incision, passingin the midaxillary line to its concavity. The vertical incision should extendto the top of the cavity. This inverted T-incision passes down to the Fig. 1096.—Result after Tho-racoplasty to Obliterate LargeCavity in Chest. 412 SURGICAL TREATMENT It is possible to do this operation with the U-incision alone (Fig. 1097).The skin-muscle flap is dissected up, and the underlying ribs resected andremoved with their intercostal muscles, unroofing the cavity. The thick-ened parietal pleura is removed at the same operation or at the next. Thecavity is thus freely exposed. The latissimus dorsi muscle is dissected freefrom the skin flap in the form of two muscular masses, split by a verticalincision. These two flaps of muscle are turned into the cavity and suturedin place, one being imposed upon the other. The skin flap is sewed back inplace over the muscle, a large opening for gauze drainage being left at thebottom (see Operations on the Lung, page 453). The muscle implantationoperation for old unhealed empye
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
