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. The breast: its anomalies, its diseases, and their treatment . d. The long thoracic and long subscapular nerves are weU serratus magnus muscle has in part been removed. The illustration shows that the subscapularvessels have been removed; this is unnecessary in the majority of mstances. The fascial sheaths cover-ing the external oblique and rectus abdominis muscles have been in part removed. Case 4.—Central part of wound sloughed. Case s.—Both ends of wound opened; infected. Case 6.—Entire wound sloughed; patient in hospital 57 days; recovered. Case 7.—Infected drainage sinus; tube
. The breast: its anomalies, its diseases, and their treatment . d. The long thoracic and long subscapular nerves are weU serratus magnus muscle has in part been removed. The illustration shows that the subscapularvessels have been removed; this is unnecessary in the majority of mstances. The fascial sheaths cover-ing the external oblique and rectus abdominis muscles have been in part removed. Case 4.—Central part of wound sloughed. Case s.—Both ends of wound opened; infected. Case 6.—Entire wound sloughed; patient in hospital 57 days; recovered. Case 7.—Infected drainage sinus; tube reinserted; hot boric acid douches; recovered. Case 8.—Abscesses in incision; axilla opened; irrigations with $ per cent, iodine; recovered. CARCINOMA 599 Case. g.—Excessive bleeding through the tube during the night of the operation; irrigation with hotsalt solution; recovered. Case lo.—Shock; intravenous saline transfusion; recovered. Case II.—Entire wound sloughed; flaps necrotic; several secondary operations; patient finally diedof Fig. 2iS.—Closure of the wound. Silkworm gut is used for the purpose. The drainage tube isbrought out through a counter puncture a little distance below the middle of the outer flap. Case 12.—Drainage tube became loosened from incisional edges and slipped into the axilla; counterincision and removal; recovered. The immediate serious complications of amputation of the breast are shock andhemorrhage. The patient may have apparently reacted from slight degrees of shock 6oo THE BREAST during the course of the operation but at its conclusion show evidences of extreme cardiacand vasomotor depression. For this reason these patients, and especially the aged, mustbe watched very carefully for some hours after leaving the operating room. We havenever transfused a patient during the course of an operation for mammary carcinoma,but in several instances have found it necessary to do so an hour or so later, when diffusi-ble stimul
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectbreast, bookyear1917