Lectures on orthopedic surgery . can be easily opened (preferably by Hil-tons method). The finger is introduced and diseasedbone felt for, and, if loose or easily detachable, operation should be performed, however advanceda retro-pharyngeal abscess may appear. It is a mistaketo incise through the pharynx, as drainage in any posi-tion of the body is thereby rendered difiicult andrisky. Dorsal abscesses may be opened where they present. 107 In the lumbar region, the vertebrse can easily bereached by an incision along the outer border of theerector spinse, cutting through the posteri
Lectures on orthopedic surgery . can be easily opened (preferably by Hil-tons method). The finger is introduced and diseasedbone felt for, and, if loose or easily detachable, operation should be performed, however advanceda retro-pharyngeal abscess may appear. It is a mistaketo incise through the pharynx, as drainage in any posi-tion of the body is thereby rendered difiicult andrisky. Dorsal abscesses may be opened where they present. 107 In the lumbar region, the vertebrse can easily bereached by an incision along the outer border of theerector spinse, cutting through the posterior fasciae andorigin of the transversalis. The middle sheath andorigin are now divided, and the quadratus lumborumis exposed. This muscle is easily known by the direc-tion of its fibers, which pass upward and inward. Thelumbar arteries cause no trouble, and the incision iskept as near to the middle line as the wound careful dissection arteries may be seen if presentand they can be clamped before division. The anterior. Fig. 72.—Direction of the lumbar incision. fascia of the transversalis origin is now seen, thendivided, and the finger passed along the front by thetransverse processes and toward the bodies. The abscesscan be easily felt by the finger, and fluctuation madeout by pressing on the abscess in the thigh or abdo-men from the front. The sides of the bodies can bemade bare by a blunt dissecting tool or closed dissecting-forceps, and the exploration completed when sequestramay be removed. Thorough washing should be abscess should be opened, and the cavity washedout, and scraped gently with the finger, or finger coveredwith gauze, when a slight general oozing of blood takesplace but soon stops. The abscess should next be 108 washed out with hot aseptic solution, preferably ofboric acid. It will be found that after the cleansing thechronic abscess-wall collapses much more readily. Theedges of the abscess-wall may then either be stitched ornot. Deep su
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectorthopedics, bookyear
