Outlines of practical surgery / Walter G. Spencer.

  • Spencer, Walter George.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of practical surgery / Walter G. Spencer. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    J52 skull to slip out of the way—e.g., from beneath a wheel— and when a blow strikes the head obliquely—e.g., a cricket- ball—the position of the scalp wound may not be opposite to the injury of the skull. The mobility of the scalp on the skull may allow of its being widely stripped up, e.g., when a woman is caught by her hair in some moving machine. The tough fibrous tissue of the scalp does not allow of such stretching as does the ordinary skin, thus when the scalp is destroyed by a burn or by ulceration, any large gap must be replaced by grafting; every tag in the case of a lacerated wound should be saved, and fixed again in position. Treatment of a Scalp Wound.—The hair is shaved off widely around, even in the case of small superficial ones. The scalp is washed with soap and water and turpentine until it becomes white, the wound is firmly sutured, and this stops most of the bleeding, except in the case of the main vessels, which require a ligature. A pocket formed by stripping off the scalp may be drained through a buttonhole made at its most dependent part. For wounds of the vertex the roller bandage is carried under the chin and above the occipital protuberance. For a wound on the side of the head the bandage is applied hori- zontally, passing beneath the frontal eminences and the occipital protuberance, each turn crossing the preceding one like the letter X. When no pressure is required, a cap of lint or a triangular handkerchief serves to keep on the dressing. Haematoma of the Scalp—Cephalhaematoma. A superficial haematoma in the scalp is always circum- scribed, not extending beyond an inch or two in diameter; a hasmatoma beneath the aponeurosis is widespread ; one beneath the pericranium is limited to the bone, generally the parietal bone, and occurs during birth. A haematoma feels soft in the middle from the fluid blood; at the margins is a hard rim, composed of inflammatory oedema, which requires to be firmly pressed with the finger before the skull can be perceived beneath. A hasmatoma is always superficial to the skull, and therefore the soft centre cannot be mistaken