110 WOUND TREATMENT 



made in perfectly sound flesh, and in working through 

 such operation we should keep in mind that the desired 

 goal is to leave at the completion of the operation an 

 aseptic traumatic cavity. With this accomplished, the 

 subsequent management consists of disposing of the dis- 

 charges which gather in the cup-like cavity as fast as 

 they accumulate. What gravitation does in the wound 

 previously described, we must now do by absorption. 

 A large traumatic cavity will pour out an enormous 

 amount of serosity between the second and fifth days. 

 To dispose of this accumulation during these days is 

 the prime factor in the treatment of such wounds, and 

 as the healing period will be materially shortened if 

 infection is controlled it is well worth while to work dili- 

 gently at the task of absorbing discharges during this 

 period — the first five days. Thereafter, as the exuda- 

 tion will gradually diminish and the walls will have pro- 

 tected themselves against invasion, this diligence may be 

 somewhat relaxed. It is, however, well to keep all wound 

 cavities as dry as possible until they are level. 



The best method we have found to take care of dis- 

 charges in large cavities is by smothering them with boric 

 acid and iodoform (95 to 5 per cent) . The cavity is filled 

 with this powder, and it is renewed three times a day 

 if it becomes soaked. While this vigilance may seem tt) 

 be considerable trouble, it is always rewarded by prompt 

 healing, and is much less trouble than that almost im- 

 possible task of handling the copious flow of pus over 

 the surface of the body, sometimes encrusted an inch 

 thick from withers to heels, constituting about the most 

 unsavory postoperative condition imaginable. The diffi- 

 culty in handling this latter condition is enormous com- 

 pared with the little trouble necessary to prevent occur- 

 rence by diligent, initial attention, lasting four to five 

 days. Furthermore, traumatic cavities of this nature 



