A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . thout much tearing of the integument, gives riseto a contused wound, while the same force so applied as freely torupture the skin as well as underlying structures is said to cause alaceration. Lacerations are distinguished by irregular jagged edges,moderate pain, slight hemorrhage, little gaping, a tendency to suppura-tion and sloughing of the edges, and slow cicatrization. These featuresdepend upon the method of injury, for it
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . thout much tearing of the integument, gives riseto a contused wound, while the same force so applied as freely torupture the skin as well as underlying structures is said to cause alaceration. Lacerations are distinguished by irregular jagged edges,moderate pain, slight hemorrhage, little gaping, a tendency to suppura-tion and sloughing of the edges, and slow cicatrization. These featuresdepend upon the method of injury, for it is the tearing and twistingof the vessels and nerves that prevent bleeding and acute pain, andthe devitalization and irregularity of the torn edges that occasionsloughing, favor microbic infection, and prevent rapid healing. Repair.—All wounds, large or small, open or cutaneous, incised orpunctured, contused or lacerated, in soft tissues or hard, heal by repara-tive processes similar to those which are seen in inflammation ; for,after all, that which is termed inflammation is natures effort to repairdamaged tissues or to prevent their further injury. Fig. Formation of new vessels by budding : a, b, c, first stages ; d,f, g, simple and branching buds ; e, tabu-lation of a bud. (TlLLMANNS.) When the wound is of such a character that accurate adjustment ofthe several [tissues can be and is accomplished, a reparative effortmerely sufficient to supply a small amount of fibrine or lymph super-venes. This fibrine glues the parts together, and then becomes changedinto granulation tissue and finally into connective tissue, or scar, anal-ogous to the original structures. Thus is repaired the breach of con- 124 SHOCK, FAT EMBOLISM AND WOUNDS. tinuity. This method of union is union by first intention, or fibrinousrepair. It occurs when no foreign body, clotted blood or undueamount of transudation prevents accurate approximation, and whenthe parts are kept quiet and the patients tiss
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