. A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . ), and then the two ends of thesuture are tied over a small i)ieeeof rubber tubing. Theoutside wound is entirely closed. The inner cavity ispacked with gauze. From ten to fourteen days later ro8 REFEREXCE HANDBOOK OF THE MEDICAL SCIENCES. IVIastoid Operations,mastoid Operatlous. the patieut is given an anojstlietic, the cavity is washedout witli a warm sterile saline solution, and the mastoidwound reopened. After all oozing has been stopped aThierschs skin graft,
. A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . ), and then the two ends of thesuture are tied over a small i)ieeeof rubber tubing. Theoutside wound is entirely closed. The inner cavity ispacked with gauze. From ten to fourteen days later ro8 REFEREXCE HANDBOOK OF THE MEDICAL SCIENCES. IVIastoid Operations,mastoid Operatlous. the patieut is given an anojstlietic, the cavity is washedout witli a warm sterile saline solution, and the mastoidwound reopened. After all oozing has been stopped aThierschs skin graft, which has been obtained in themean time from another portion of the body, and whichis large enough to cover completely the granulating sur-face of the cavity, is carefully apidied to this areaand then covered with gold leaf. The cavity isplugged with sterile gauze which is left in place for two orthree days. At the end of this period the gauze shouldbe removed and the gold leaf gently washed out. Bal-lance claims for this mode of operating amuch shorter period of the class of cases which we are now. Fig. —The Concho-meatal Flap is seen Behind the Mastoid sutures ai-e passed tliroueh it anil the two ends of each sutureare then threaded on one needle and passed through the mastoidflap and then tied over a piece of rubber tubing. (From Jaeobsonand Steward: The Operations of considering, the after-treatment requires much should not be resorted to if it can be avoided; asa substitute, very gentle dry cleansing is to be first dressing need not be disturbed for or sevendays unless the temperature denotes a septic disturbance;subsequenth. however, the parts will have to be dressedevery other day. The sutures are geucralh removed atthe time of the first dressing. The gauze drain in thelower end of the mastoid wound is to be short-ened utilil the wound has healed from the bottom. E-\
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