Notes of cases illustrating surgical lesions of the vascular system / by Rudolph Matas.

  • Matas, Rudolph, 1860-1957.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Notes of cases illustrating surgical lesions of the vascular system / by Rudolph Matas. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of the wound was promptly secured with a Tait’s clamp, which was left in situ. The wound in the superficial arch gave no trouble and all further oozing was readily controlled by a firm iodoform gauze pack. A long extensor splint reaching to the elbow was then applied and the arm was thus immobilized. Three days after, the splint was removed and the hemostat un- damped. The wound had a healthy appearance and finally healed without accidental complications. This case is presented to illustrate a simple method of treatment for an injurj?- which is not rare and which is likely to cause no small amount of worry to the inexperienced prac- titioner. It is well known and admitted that the ligature of the arteries in the forearm for a bleeding palmar arch is untrustworthy, and that nothing short of the ligation of the brachial at the bend of the elbow above the bifurcation, as recommended by Thiriar, of Brussels, can give security against secondary hemorrhage. But the ligation of the brachial at the] bend of the elbow, simple as it may appear to the surgeon of experience, is nevertheless an anatoniicxl operation which many practition- ers will hesitate to attempt. Furthermore, it is always unsur- gical to ligate a parent trunk when it is possible to control the bleeding vessel at the bleeding point. The danger of septic teno-synovitis has been the chief drawback in the past against the ligation of the deep palmar vessels. The difficulty of securing a bleeding vessel in the depths of the palm has also discouraged the application of the ligature in the wound, and favored ligation at a distance, but the modern methods of anti- sepsis and hemostasis have greatly cleared the field of these objections. The practitioner of the present day should find no more difficulty in controlling a palmar heemorrhage in loco than he would in dealing with bleeding in wounds of other localities.