Modern surgery, general and operative . Absence of granulations or scantiness ofgranulations means deficiency of blood-supply. The surgeon endeavors tobring more blood to the part, and to do this induces inflammation. Theusual method of procedure is to apply daily to the sore a solution of nitrate of silver (lo or 15 gr. to theounce). Argyrol of a strengthof 25 per cent, is not painfuland is as efficient. In ob-stinate cases blister the ulceror scrape it, or paint it withtincture of iodin, or applypure carbolic acid, or touchit with the actual many cases granulationis greatly stimu
Modern surgery, general and operative . Absence of granulations or scantiness ofgranulations means deficiency of blood-supply. The surgeon endeavors tobring more blood to the part, and to do this induces inflammation. Theusual method of procedure is to apply daily to the sore a solution of nitrate of silver (lo or 15 gr. to theounce). Argyrol of a strengthof 25 per cent, is not painfuland is as efficient. In ob-stinate cases blister the ulceror scrape it, or paint it withtincture of iodin, or applypure carbolic acid, or touchit with the actual many cases granulationis greatly stimulated by atwenty-four-hour applicationof an 8 per cent, ointment ofscarlet red. If it causes irri-tation its use is suspendedfor a day or two, and thenthe ointment is reapplied. Ifan ulcer of the leg becomespainful at one point (see page157), touch with pure car-bolic acid after curetting, orfind the painful spot witha probe and divide the ex-posed nerve filament with the methods of skin-grafting(See Plastic Surgery.). Fig. 81.—Strapping an ulcer of leg (Keens Surgery). If healing entirely fails, skin-graftare—(i) Reverdins, (2) Thierschs, and (3) Wolfes When a man having an ulcer must go out and about, the camphor treatmentcan be employed (see page 155), Unnas dressing may be applied (see page 154),the patient can use a firmly applied roller or, better still, a Martin bandage, which is made of red rubber, limits the amount of arterialblood going to the ulcer and favors venous flow from the sore and its neigh-borhood. The bandage should be used as follows: Before getting out of bedspray the sore with hydrogen peroxid by means of an atomizer, remove the frothwith absorbent cotton, wash the leg with soap and water, dry it with a towel, dustthe skin with borated talcum powder, and apply the bandage from the toes of these things should be done before putting the foot to the floor. Atnight, after getting on the bed, remove the bandage, wash
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