TREATMENT 87 



answer for the after-care, but where the cavity 

 was found badly infected or in instances where 

 the operation was not a perfectly clean one, it 

 is essential that the powder be renewed no less 

 frequently than three times a day for the first 

 four days. By attending with great care to 

 this large wound, the discharges will not be 

 abundant, but when the whole area of exposed 

 flesh is allowed to become contaminated the is- 

 sue is copious. It is, therefore, important to 

 pay strict attention to the wound, treating it 

 skillfully during the first four days. After 

 four days there is less danger of grave infec- 

 tions gaining any headway in the wound as 

 the tissues are then better protected against 

 microbian invasion. 



The drainage tube is managed much like a 

 seton. We fasten a spike across one end and 

 then pull it through from the other end and 

 give the holes and lumen a good cleaning. A 

 stylet is needed to dislodge the dried pus that 

 chokes it. By bending it about, cleaning its 

 holes and ramming a stylet through its lumen 

 and then rinsing it well with a strong antisep- 

 tic solution, it can be kept perfectly clean and 

 open. The next day the same manner of hand- 

 ling is repeated except that it is draw^n to the 

 opposite side. 



Cases having an osseous comjilication should 



