. American practice of surgery ; a complete system of the science and art of surgery . a does. In bedsores that occiu- in this region, in patients suffering from some pro-tracted and exhausting disease, it is well to bear in mind the possibUity of apre-existing cyst or sinus which has become infected. The clean-cut characterof the opening and the firm, well-defined wall of the sac or sinus are featureswhich contrast strongly T\-ith the flabby, necrotic subcutaneous fat and imder-mined skin of a bedsore. Treatmext.—Thorough excision of the wall of the sinus or cyst should bedone to prevent recu
. American practice of surgery ; a complete system of the science and art of surgery . a does. In bedsores that occiu- in this region, in patients suffering from some pro-tracted and exhausting disease, it is well to bear in mind the possibUity of apre-existing cyst or sinus which has become infected. The clean-cut characterof the opening and the firm, well-defined wall of the sac or sinus are featureswhich contrast strongly T\-ith the flabby, necrotic subcutaneous fat and imder-mined skin of a bedsore. Treatmext.—Thorough excision of the wall of the sinus or cyst should bedone to prevent recurrence. Simple as this treatment is. it is smprising howmany cases are inefficiently treated by incision and drainage, the pecuhar charac-ter of the lining membrane of the sinus or cyst causing recurrence of abscessesor a persistent suppurating tract. An elliptical excision should be made aroimd all sinus openings and the dis-section should be carried through the normal subcutaneous fat, well outside thelining membrane of the sinus. In its deeper parts this lining membrane Hes in. Fig. is.—Sacro-Coccygeal Sinuses. Xote two distinct openingsin the skin, and their position about two and a half inches abovethe margin of the anus. (Photograph of the ease shown in Fig. the incision was made.) 24 AMERICAN PRACTICE OF SURGERY. close contact with, and is usually adherent to, the periosteum of the lower partof the sacrum, and care should be taken to make its removal comjilete. Thewound may then be closed by suture, with or without a small rubber-tissue draininserted at the lower angle. It is important that ample gauze pads should beplaced over the wound and secured by broad strips of adhesive plaster, in orderto obliterate dead spaces and prevent sliding or lifting of the flaps. Even in suppurative cases it is often possible to obtain healing by primaryunion, if the pus is evacuated and the cavity thoroughly swabbed first with purecarbolic acid and then with alcohol or per
Size: 1676px × 1492px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
