864 CHAPTER 48. 



744. Dressing for Wounds intended to be healed by Adhesion. 



For wounds capable of being healed by adhesion, lint steeped in Friar's 

 balsam or collodion may be applied. Where collodion is used, the hair 

 about the part must be removed. Or glue, or shellac plaster may be 

 applied to keep the edges of the wound in apposition after removing hair 

 from the edges of the wound. 



745. Dressing for Wounds intended to be healed by Granulations. 



For wounds intended to be healed by Granulations, there is no better 

 dressing than lint steeped in cold water. Care must be taken to keep 

 the lint moist, and for this purpose it may be covered with oil-skin or 

 gutta-percha. Or carbolised oil may be applied with a feather. The 

 carbolic spray, as recommended for open joints, will be found very useful 

 in cases of extensive granulating wounds. These means will be found far 

 preferable and more effectual than the Digestives used in olden time, 

 when Surgery was in its infancy. Nature alone can heal. We only assist 

 her by preventing the interference of retarding influences. 



746. Wounds, healing by Granulations, to fill up from the bottom. 



All wounds healing by granulations must fill up gradually from the, 

 bottom. It must be remembered that there is a greater tendency to union 

 in the edges of the skin and in parts near the skin than in deeper tissues. 

 Hence, all deep wounds require to be kept open, until we are assured that 

 the healing process is fully completed from the lowest part. This object 

 may generally be obtained by inserting a piece of dry lint between the 

 edges of the wound. 



The formation of a slight scab over the exterior of the wound is useful 

 in many cases as a protection against the irritating effects of the air and 

 accidental abrasion; but no dense firm unyielding scab should be per- 

 mitted to form or remain, because it will unduly check the natural 

 exudation of the matter, which in such wounds always forms. The 

 matter, if confined, will collect until at last it bursts out by some large 

 irregular opening, or, if unable to obtain an exit, will burrow in the 

 deep-seated tissues and cause extensive mischief. 



747. Indolent Wounds. 



If a wound, which is healing either by scabbing or by granulations, 

 becomes indolent, and the healing process is slow and imperfect, it may 

 be necessary to rouse the parts to more energetic action. If the wound is 

 merely in the skin, the edges of it may be removed Avith the knife, and 

 the cut surfaces brought into contact and kept together by sutures. In 

 other cases caustic may be applied to the wound, or the neighbouring 

 parts may be lightly blistered. 



Indolence in the healing process is a sign of constitutional debility. 

 Hence, in addition to local measures, the general health should be care- 

 fully attended to. 



