The principles of surgery . le. For, once removed, itwill not be reproduced; and the limb, in consequence, may be perma-nently and unsafely weakened, as well as deformed. The sequestrum having been duly exposed, the laying hold of itcomes to be of some consequence. Forceps are the best adapted in-strument; but, in general, they are used much too small and common dressing forceps, as found in the ordinary pocket case, arequite unsuitable; except for very small sequestra, wholly unconfined bycortical formation. Strong blunt pliers, made for the purpose, shouldbe employed; like bell-ha
The principles of surgery . le. For, once removed, itwill not be reproduced; and the limb, in consequence, may be perma-nently and unsafely weakened, as well as deformed. The sequestrum having been duly exposed, the laying hold of itcomes to be of some consequence. Forceps are the best adapted in-strument; but, in general, they are used much too small and common dressing forceps, as found in the ordinary pocket case, arequite unsuitable; except for very small sequestra, wholly unconfined bycortical formation. Strong blunt pliers, made for the purpose, shouldbe employed; like bell-hangers pliers, only longer in both blade andhandle, with the former well serrated to prove surely prehensile, andpowerful in every part. By means of these the dead portion is firmly 404 TREATMENT OF NECROSIS. grasped; and is moved to and fro, so as to insure its freedom from thesurrounding substitute. Then, by a steady pull, it is brought to thesurface; leverage power being used, if need be, to break up any farther Fig. Forceps suitable for removing sequestra. obstacle which may obstruct its final removal. Such determined proce-dure saves pain, time, blood, and trouble. For the smaller and shorterinstrument is prone to slip ; only after repeated eiforts is a truly securehold obtained by it; and thus often much wriggling and real force arerequired, to overcome unexpected obstacles by unequal means. Whenthe sequestrum is long, and the main aperture leads to its middle ratherthan to either extremity, extraction is often much facilitated by cuttingthrough its centre with the bone pliers, and then extracting each portionseparately. Thus, then, the errors most likely to occur, in the manual treat-ment of necrosis, are three: too early an interference, ere the naturalprocess of separation has been accomplished; attempted removal of thedead portion, when loose, by inadequate means ; and the leaving of itundisturbed, when loose, throwing on Nature the labor of extrusion aswell as o
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