On some important advantages to be secured by oblique section of the skin in surgical operations / by John H. Packard.

  • Packard, John H. (John Hooker), 1832-1907.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: On some important advantages to be secured by oblique section of the skin in surgical operations / by John H. Packard. 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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    perfectly dry and clean. The wound was closed with three points of the hare-lip suture, and adhesive strips. Carbolized cerate was applied as a dressing, and gentle, equable pressure made with a wad of raw cotton. On the third day the pins were removed. On the fifth, the wound was found to be solidly united from one end to the other, there not having been a fluidrachm of pus formed. Another case was that of amputation of the fore-finger at the metacarpo-phalangeal joint, for injury by the thrust of a needle, causing cellulitis and wasting, with painful atrophy of the soft parts. The incisions were so made as to bring the cicatrix on the upper part of the stump, the outer flap being beveled from within outward, the inner from without inward. Here there was some sub.sequent pain, and a dressing of hot laudanum was applied for about twenty-four hours. A perfectly dry healing ensued, with an absolutely linear cicatrix. No dressing whatever was used after the third day, a strip of dry lint only being put on as a protection. Another case was one of strangulated inguinal hernia of the right side, operated on April 19th. The incision was made by carrying the knife in very obliquely, and dividing the skin in that manner for the requisite distance. The hernia was reduced with- out opening the sac. One vessel required ligation, which was done with carbolized catgut. Four or five hare-lip pins were employed for the closure of the wound, and one silver-wire suture, fastened with lead plates at either end, through the deeper tissues. A superficial silver-wire suture was also used at the lower end of the wound. All these sutures were rercoved on the third day. No dressing was used but carbolized cerate, with a thin sheet of raw cotton over the whole of the region involved. The healing, although not absolutely dry, was very nearly so; there was never more than f5j of pus on the lint taken off. The cicatrix is a mere hair-line in appearance, and there is no tenderness, even on firm pressure. No argument is necessary to show the advantage, in such a case as this, of a firm and deep union of the edges of the wound, with as small an amount as possible of cicatricial tissue to be pressed upon by the truss, which prudence will oblige this patient fo wear for a time.