192 OPERATIONS ON THE SKIN AND CELLULAR TISSUE. 



« 



The first effects following the application of a seton are those 

 met with in a majority of ordinary wounds ; more or less swelling 

 and inflammation, followed by an access of the suppurative pro- 

 cess. At the points of insertion and exit of the needle, a certain 

 amount of hemorrhage takes place, generally of no importance, 

 and subsiding without interference, and this is succeeded by a 

 swelling along the braid of the seton, at first more or less diffusi- 

 ble, with a tendency to increase during the first forty-eight hours 

 but then becoming more defined. In the beginning, and for the 

 first two days, there is a flow of a thin serosity from the opening 

 of the seton, which gradually assumes the character of suppura- 

 tion of good quality in the shape of creamy, laudable pus. Up to 

 this period the seton needs no attention, and should be left with- 

 out interference, to exhibit the natural traumatic effect of its 

 presence. Although it is desirable to have the suppuration well 

 estabhshed and flowing freely, it must not be permitted to accumu- 

 late in the tract, and should be subjected once or twice a day to 

 gentle pressure along the entire length of the seton, to expel the 

 least portion of purulent matter present. At the same time, such a 

 pressure as would be hkely to crush the granulations of the wound 

 and thus excite small hemorrhages, must be avoided. 



The cleaning and washing of the oj)enings of the seton, and of 

 the tape itself, must be carefully and strictly performed as often 

 as the abundance of the discharge requires it. It should be sys- 

 tematically attended to, not less than once or twice daily, at the 

 least. Precautions must be taken to prevent the animal from 

 biting and pulling off the seton, and yet this accident is very 

 possible, and it may frequently become necessary to replace it. In 

 that case the needle should be introduced by its blunt end, with 

 the new tape previously inserted in the eye. At times it becomes 

 necessary for other reasons to renew the seton. A feasible way 

 to effect this will be to attach the old tape to the new, and draw 

 out the former by means of the latter. The length of time a 

 seton ought to be allowed to remain in place varies according to 

 circumstances, extending to a period of from thi'ee to four weeks, 

 or even longer. 



"When the time has arrived for the discontinuance of a seton, 

 if more than one have accomplished their purpose and had the 

 desired effect, they ought not to be all removed at the same time, 

 but singly, and with an interval between them. Nor must the 



