92 FISTULA AND POLL-EVIL 



from septicemia, even in the most vigorous sub- 

 jects. 



The prevention hes in making the best of 

 the situation by using sterihzed instruments, 

 cleaning the hands well, packing the wound 

 with a safe wadding and then protecting it 

 thereafter until the danger of a grave infection 

 has passed. It is also very essential to remove 

 the packing material at the end of twenty- four 

 hours so that the blood supply of the tissues 

 pressed upon by the tight packing will be re- 

 stored to the walls of the wound. A packing 

 of doubtful purity wadded tightly into a 

 wound as large as this one is indeed a hazard. 

 It weakens the tissues and besides impregnates 

 them with infections. 



Malignant Edema 



We have had cases of malignant edema fol- 

 low operations where the directions given about 

 the removal of the packing were not carried 

 out. To let a packing sojourn forty-eight 

 hours in a large wound always invites anaer- 

 obic infections of this character. In fistula of 

 the withers it is positively disastrous. There 

 is danger from this disease even after appar- 

 ently clean operations because the condition 

 created is so favorable. The prompt removal 

 of the packing at the end of twenty- four hours 



