INCISED WOUNDS. 451 



contact, a " pin-director," with the pin in its concavity, is to be 

 introduced from the outside inwards, and carried out through 

 the opposite side to the same distance from the edge that it 

 entered on the former side; the director is then withdrawn, 

 and the pin left in and secured in its position by a firm wax 

 ligature passed around it, maldng the figure of 8, hy which the 

 wounded parts are drawn gently into contact. The number 

 of pins is to be determined by the size of the wound ; three- 

 quarters of an inch to one inch is a proper distance between 

 two pins. 



The Quilled Suture. — When pressure is required on the deep 

 as well as the superficial parts, this form of suture is employed. 



This suture is best applied with a strong curved needle, fixed 

 in a handle, and having an eye near the point. This can be 

 threaded with the loop of double twine, strong thread, or catgut. 

 The needles must pierce the skin not closer than an inch from 

 the edge, deeply inserted, and brought out at the same distance 

 beyond the opposite margin of the wound. This will leave a 

 double thread through the wound, with a loop on one side and 

 two free ends on the other. Through each loop so formed a 

 piece of whalebone or cane should be passed, and the threads 

 firmly drawn over it, while the free ends are firmly tied over a 

 similar piece on the opposite side of the wound. To maintain a 

 more perfect apposition in the more superficial parts, a few in- 

 terrupted sutures may be inserted to the margins of the wound. 



When an injury is superficial, sutures are not required ; and 

 in parts where plasters cannot be applied they can be kept in 

 apposition by collodion, styptic-colloid, or, what Is more economi- 

 cal, a thick solution of shellac in methylated spirit, which may 

 be prepared and kept ready for use in a wide-necked bottle with 

 a tight-fitting cork. 



As to local applications to incised wounds, fortunately the 

 days are past when greasy ointments, friars'-balsam, black oils, 

 and other irritating abominations were made use of, and now-a- 

 days wounds are left alone. If anything be done at aU, the 

 best application to the surface of the skin around the wound is 

 the ordinary white lotion, gently squeezed out of a sponge, and 

 allowed to trickle over the surrounding skin ; care being taken 

 that the sutures are not disturbed, nor the dried discharge 

 which covers the surface of the fissure removed. Fomentations 



