128 SURGICAL DRESSINGS. 



placed interrupted sutures. Bayer insisted on the importance of 

 drawing up a fold of skin, thus producing a ridge \ inch high before 

 inserting these sutures. A large piece of iodoform gauze was spread 

 over the whole field of operation and fixed to the rubber tubes used 

 for securing the sutures of relaxation. The gauze covered the 

 drainage-tube. The horse was then allowed to rise and the space 

 marginated by the rubber tubes was protected with a pad of dressing 

 material which was caused to press on the wound by thrusting broad 

 strips of thin elastic wood, similar to that used in the manufacture 

 of hat boxes, under the rubber tube on either side. This brought 

 the surfaces of the wound together and facilitated union. The trifling 

 local prominences caused by the stitches did not prevent the appli- 

 cation of a well-fitting collar and usually disappeared in a month 

 or two, leaving a scarcely visible linear scar. 



The dressings used in fractures of bones may be divided into two 

 kinds, viz. those of a temporary character — -termed provisional — and 

 those intended to be more lasting — permanent dressings. The choice 

 for the first dressing is often very restricted, and whatever first comes 

 to hand may require to be used. In this case broad strips of linen 

 or even of sacking are sometimes first applied as a padding and 

 support, and the splints, formed of flat pieces of wood, are applied 

 on either side of the long axis of the bone and fixed in position by 

 cords or straps. Pieces of wood may be replaced by bundles of straw. 

 The broken part being thus protected the horse should be removed 

 as rapidly as possible to the stable, and the permanent dressing 

 applied. If time permit the supporting pieces of wood may be sewn 

 between linen pads. To increase the firmness of the dressing rolls 

 of straw, lengths of sole leather, straw board, or pieces of lead 

 moulded to the shape of the part, can be employed in place of wooden 

 splints. 



Permanent dressings are prepared with starch, dextrin, plaster, 

 tripolith, glue, gutta-percha, plastic cardboard, and poroplastic felt. 

 When applying any of these care must be taken that the broken 

 parts are first replaced as nearly as possible in their natural positions, 

 and so retained until the dressing has become quite hard. The 

 dressing must not press unduly on any point as this would cause 

 sloughing of the skin, a complication specially liable to occur where 

 prominent bony processes have to be included in the dressing. The 

 portions to be covered and their immediate neighbourhood are there- 

 fore first supported by the application of a sheet of linen, over which 

 wadding or some soft material is thickly applied and is retained in 

 position with a soft bandage. Instead of wadding, soft flannel 



