LAMENESS IN THE FORE LEG 113 



ling of such cases, and many practitioners are not only thought- 

 less in this part of their work, but also apparently careless. 

 What does it profit to prepare a part and cleanse a wound with 

 painstaking care and then neglect to take every possible precau- 

 tion to prevent its subsequent contamination? 



In the handling of open joint capsules where the perforation 

 of the capsular ligament is small and discharge of synovia does 

 not immediately follow, there is presented a problem which is 

 difficult to decide upon and that is the manner in which such 

 wounds are to be handled. One hesitates to enlarge such open- 

 ings to drain or irrigate the capsule when there is no proof that 

 serious trouble will follow because of infectious material which 

 has probably been introduced at the time the wound was in- 

 flicted. It is especially difficult to decide upon the manner of 

 handling such cases where the tarsal joint is wounded, although 

 one hesitates to invade any joint to the extent of incising its 

 capsule, unless there is urgent need of so doing. 



Frost ^ offers the following suggestion in such instances : 

 The treatment recommended by us for open joints, in which 

 we wish to prevent ankylosis, is, first, to shave all hair from the 

 area surrounding the wound, following v>'ith a thorough cleans- 

 ing of the skin and disinfection of the v/ouud, and then to in- 

 ject a twenty per cent Lugol's solution in glycerin into the 

 wound. This should be repeated two or three times a day, each 

 time enough of the solution being injected to fill the joint cap- 

 sule, thereby securing the flushing effect. As this solution does 

 not cause irritation to the tissue and yet is a strong antiseptic, 

 it serves to shorten the period of congestion and inflammation 

 and to overcome the infection without causing a destruction of 

 the secreting membrane until the external wound has had time 

 to heal. The injection of this solution seems to retard the ex- 

 cessive secretion of synovia. The larger the joint capsule and 

 the smaller the external wound, the longer our antiseptic will 

 remain in contact with the inflamed tissues as the glycerin, 

 being thick, does not flow through a small opening. 



After-care. — Following the initial cleansing and treatment of 

 open joint, subsequent dressing is necessary as frequently as 

 conditions demand. If the parts are badly infected and profuse 

 discharge of pus exists a daily change of dressings is necessary. 



ij. N. Frost, assistant professor of Surgery, Veterinary Dept., Cornell 

 University, in "Wound Treatment," page 159. 



