96 WOUND TREATMENT 



This wound distinguishes itself therapeutically from 

 the incised wound because provision must be made for 

 the escape of the serum that will exude from its walls, 

 which would fill up the cavity to the physical detriment 

 of the healing process and the decided advantage of in- 

 vading microbes. Even though a wound is aseptic it must 

 never be allowed to harbor its secretions in any consider- 

 able quantity. Wounds of animals filled with serum be- 

 come putrid despite everything. 



Treatment. — If such a wound is surgical, every effort 

 is made to prevent soiling of the tissues during the opera- 

 tion. If any are soiled by contact with dirt or flowing 

 pus, these are trimmed off with the scissors or scalpel 

 rather than depending upon any form of chemical ablu- 

 tion, the aim being to have at the end of an operation a 

 traumatic cavity that is absolutely free from micro-organ- 

 isms. The surroundings having been previously shaved 

 and disinfected, the wound is now ready to cover over by 

 suturing. An opening at the end of the cavity, or a 

 counter opening especially made, is provided for the 

 escape of the serosity that will exude more or less 

 copiously during the succeeding week. If the orifice thus 

 provided is simply kept open so that every dram of the 

 discharge will flow out, there is no other treatment re- 

 quired except tha^t of maintaining a suitable protection 

 of the sutured portion against external contamination 

 and injury. If infection of the cavity is prevented dur- 

 ing the first five days there will be less chance for any 

 successful invasion of microbes thereafter. That is, the 

 first few days, while the tissues are still weakened from 

 the injury they have sustained and before a protective 

 reaction has developed, is the time during which special 

 care must be taken to prevent them from being inocu- 

 lated with the gauze, the syringe, the fingers, or any 

 object that may be needed to keep the orifice working 



