60 WOUND TREATMENT 



severed is the ascending branch of the inferior cervical 

 artery. In many instances I have located and ligatured 

 this vessel prior to incising the parts in the vicinity and 

 thus saved much subsequent trouble and time. And 

 here I may remark that in every instance and in every 

 region when we come across a vessel that is likely to be 

 severed during the operation, it is a good plan to ligature 

 it before proceeding further. 



Large pressure forceps are useful to hold deep-seated 

 portions of the tumor. The growth is severed along 

 the edge of the forceps, and any vessels that are cut can 

 be seen and readily secured before the structures are 

 let go. 



After the tumor has been removed, and all bleeding 

 points secured, I advise packing with carbolized tow in 

 order to combat any danger of secondary hemorrhage. 

 Healing by first intention is not to be expected, and the 

 packing can be removed wdthin twenty-four hours. I 

 have met with very serious secondary hemorrhage from 

 cases of this kind, and hence I find that firm packing 

 immediately after operation is the best plan to adopt. 



When secondary hemorrhage does occur, it is very 

 difficult to suppress; these tumors have such extensive 

 vascular attachments that bleeding may be very profuse, 

 and when it occurs at night time, and is not immediately 

 observed and checked, a fatal result may ensue. In the 

 case of a quiet animal, the bleeding vessel may be located 

 and secured, but otherwise it may be necessary to cast 

 the patient in order to carry out the necessary pro- 

 cedure. 



In less severe cases, firm plugging with tow and deep 

 suturing of the edge of the w^ound will prove successful. 

 In the case of all wounds the great objection to firm 

 plugging is the extensive swelling that usually results, 

 therefore I always prefer, when possible, to secure the 



