86 THE SURGICAL ANATOMY OF THE HORSE 



obliquely towards the skin, the loose fold of which is held tightly in 

 the other hand. This will render easier the passage of the blade 

 through the subcutaneous fascia, and prevent incisions being made 

 into the growth. A considerable amount of hemorrhage is thus 

 avoided. 



Having dissected the two flaps of skin as far back as possible, a strong 

 tape should next be passed through the growth. The tape is then 

 utilised to pull the latter outwards towards the operator, who is thus 

 enabled to complete the dissection. Sutures should now be loosely 

 inserted, and the animal allowed to rise, when the sutures are tied and the 

 patient put into slings. The wound is allowed to heal from the bottom 

 by granulation, and during the formation of granulation tissue the 

 sutures should be removed. 



Care must be taken in making the cutaneous incisions not to remove 

 too much skin, otherwise, after removal of the growth, the skin over the 

 part is too tense, with the result that the process of healing is retarded. 

 On the other hand, if too little skin be removed, when the parts have 

 healed a loose fold of skin hangs from the elbow. It is necessary, 

 therefore, to examine the growth carefully before deciding upon the 

 amount of skin to be removed. 



Should the growth extend forwards, particularly on the outer aspect 

 of the limb, dissection of its anterior border from the subjacent structures 

 entails a greater amount of caution, on account of the proximity to the 

 elbow joint. 



There are several methods of preventing the affection, some of which 

 will be readily deduced from what we have already said. One is to shoe 

 the fore feet with shoes having .short branches and without calkins. 

 Sufficient bedding is also indicated. Another method is to attach apiece 

 of felt eighteen to twenty-four inches long to the rug on either side. 

 When the roller is applied, the felt passes over the elbow and effectively 

 protects it from injury. Various pads are also used, such as Offert's, 

 which is suspended from the shoulders and protects the elbow, roller 



