Excision of the knee-joint : a description of a new apparatus for the after treatment : with illustrative cases / by Patrick Heron Watson.

  • Watson Patrick Heron, Sir, 1832-1907.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Excision of the knee-joint : a description of a new apparatus for the after treatment : with illustrative cases / by Patrick Heron Watson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    applied by a large painter's brush. When the application has solidified, the patient may then be removed to bed, and the limb suspended from the running pulley of a Salter's swinging cradle, or from the roof-bar of the common iron-wire cradle employed to support the weight of the bed-clothes. I do not regard it as a matter of indifference whether plaster-of-Paris or paraffine is used. Each has its advantages. The plaster-of-Paris is firmer and not liable to be affected by heat like paraffine, but it has the disad- vantage of permitting soakage of discharge ; it takes longer to con- solidate, and when consolidated, is less easily clipped through by means of bandage-shears than the paraffine apparatus. I have of late, in the treatment of excisions and of compound fractures, em- ployed the plaster-of-Paris as the substantial substratum, and thereafter applied the paraffine over it as soon as consolidation and drying has become complete, so as to secure its greater toughness, and its complete impermeability to fluids of any kind, whether blood, serum, or pus, from the line of incision, or water from the wet dressings which may be applied during the healing of the wound. The foot and limb should not be much raised above the level of the mattress upon which the patient lies, as this is apt to lead to an awkward position of the limb when the patient first begins to move about. When in bed, the sacrum and liips must be protected from all risk of inordinate pressure, by means of a large square corrugated air-cushion completely covered with a blanket and draw-sheet. This will be found to be most evenly and comfortably supported upon a firm hair-mattress, laid either on a thick hair-palliasse, or better, a spring-bed. The patient should be encouraged to sit up as much in bed as he can, even witliin a day or two of the operation, and as soon as it is possible should be removed out of bed during the day, either to another bed or couch, or should such not be attainable, to a mattress laid upon the floor. In sitting up, the air-pillow placed beneath upon tlie seat will be found a great comfort, as it admits of easy relief to the irksomeness of maintaining nearly the same sitting posture for a period of several hours.