WOUNDS 225 
explains shortly the position of the operation wound and 
the structures involved, rendering further description un- 
necessary here. 
The operation ended, the dressing follows. Upon this 
depends very largely the ultimate recovery of the patient, 
for it is only by careful attention and suitable dressings 
that effectual repair of the injured structures may be 
brought about. 
A light shoe is first tacked on to the foot, and those 
portions of the horny sole that have been allowed tc remain 
dressed with Venice turpentine, tar, or other thickly- 
adherent antiseptic. 
The exposed soft tissues are then dressed with pledgets 
of.tow* soaked in alcohol and carbolic acid. This dressing 
must be allowed to remain in position, and is kept there by 
means of a bandage, or the shoe with plates (Fig. 55) and a 
bandage over it. No pressure is needed ; consequently, the 
pledgets of tow must not be too thick. 
In the after-dressing of the wound careful attention must 
be paid to the granulating surface. Where tending to be- 
come too vigorous in growth it should be held in check by 
suitable caustic dressings. At the same time it must be 
remembered that the granulating process of repair is 
always more rapid upon the plantar cushion and fleshy 
sole than upon the bone, or upon tendinous or cartilaginous 
structures. Asa result of this we have a wound showing 
various aspects of cicatrization. Healthy granulation may 
be profuse in one spot, while in another it may be checked 
either by a flow of synovia from the still open bursa, or 
by fragments of bone or of tendon still acting as foreign 
bodies in the wound. These latter may be readily detected 
by their standing out as dark and uncovered spots in the 
healthy granulation around, and should be at once removed. 
* When using tow in the form of ~ pad, it is well to remember that 
many small balls of the material rolled lightly in the palm of the 
hand and afterwards massed together are far better than one large pad 
of the tow taken without this preparation. The irregularities of the 
wound are better fitted, and the whole dressing easier remains in situ 
(H. C. R.). 
15 
