WOUNDS AND INJURIES. 467 



sutures are not used, the skin should be attended to in this 

 respect; otherwise the part, when healed, will present an 

 uglj blemish. To the want of care, in this respect, may in 

 general be attributed the ugly blemishes which remain after 

 the healing of wounds. It is seldom the skin requires to be 

 forced from its adhesions more than once to prevent con- 

 sequences of this nature. 



Y. — "Whatever kind of suture is resorted to, the operator 

 should secure firm hold of the skin, and make the sutures 

 no tighter than what suffices to hold the divided edges 

 properly in contact. 



VI. — The lowest part of a wound should be left more 

 open than any other, to allow free exit to any serous exuda- 

 tion which may collect. Such exudation not unfrequently 

 carries away particles of dirt, or other foreign bodies of a 

 minute kind. 



VII. — "When sutures are properly fixed, let them remain 

 until the wound is thoroughly healed. It has been taught 

 that sutures excite unnecessary inflammation, and that, in 

 consequence, they should be removed as speedily as circum- 

 stances will permit ; this is an error. On the contrary, 

 they excite little or no inflammation. Sutures, unless loose, 

 and frequently disturbed, are all but inert. 



A few remarks on the state of the wound before sutures 

 are inserted, and we close this part of our subject. Before 

 sutures are inserted, the injured vessels should have ceased to 

 bleed ; or the operator should be certain that a clot of blood 

 is not enclosed within the surface of the injury. A clot of 

 blood, so enclosed, will act as a foreign body and produce 



