Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . to the ligature. If the lobe is thick,bleeding may be prevented by multiple ligatures instead of one, or theangiotribe may be used. After resecting from two sides of the thyroid THE NECK 385 Mayo warns against letting the two stumps fall together at the median line,lest they unite and the scar contracture later compress the trachea. Ifpressure of an old goiter has caused absorption of rings of the trachea,(andthe trachea collapses when the goiter is removed, a tra
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . to the ligature. If the lobe is thick,bleeding may be prevented by multiple ligatures instead of one, or theangiotribe may be used. After resecting from two sides of the thyroid THE NECK 385 Mayo warns against letting the two stumps fall together at the median line,lest they unite and the scar contracture later compress the trachea. Ifpressure of an old goiter has caused absorption of rings of the trachea,(andthe trachea collapses when the goiter is removed, a tracheotomy tube mustbe inserted, or a piece of costal cartilage put in to hold the tissuesfrom collapsing. Sponging should be most gentle. All bleeding should be muscles and fascial planes should be restored by suture (Fig. 1082).The wound may be closed without drainage by a subcuticular suture. It iswise to leave in a drain for a day. A dressing, making even and,gentlepressure, should be applied. The patient should lie quietly in bed, on hisback, with the head and thorax slightly elevated. ,STERN0-HY0jMUSCLE- Wt. Fig. 10S0.—Operation for Goiter. All muscles retracted and capsule incised. The superior thyroid vessels are seen at the upper pole of the gland. {After Mayo.) For enucleation of a nodule, cyst or localized tumor, growing in thethyroid, the fascia or gland tissue overlying the tumor is incised, and bluntlydissected back to expose the growth to be enucleated. As the dissectionproceeds, wide retraction should be maintained and vessels passing betweenthyroid and tumor should be divided. Sometimes there may be but littleof the gland left outside of the growth; in which case mass ligature of themain vessels may be required. When the growth to be removed constitutesmost of the thyroid, and there is but little gland outside of it, this remaininggland tissue should be accorded the greatest deference. It should not betraumatized, its blood supply should not be h
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
