CHAPTER I. 



Surgical Processes— Elementary Operations. 



Surgical operations consist of the execution of one or 

 more fundamental processes or methods which, either alone 

 or combined, constitute a completed surgical procedure. A 

 knowledge of them is a knowledge of the art of surgery. 

 They are to the art of surgery what pathology is to the sci- 

 ence. They are fundamental ; basic. 



The common surgical processes,— the so-called element- 

 ary operations,— are:— Incision, dissection, ablation, resec- 

 tion, amputation, ecrasement, aspiration, ligation, cauteriza- 

 tion, phlebotomy, lancing, setoning, suturing, and firing. 



Incision. 



DEFINITION. — Incision is the simple division of tissues 

 with a sharp instrument. It is the loss of continuity with 

 minimum injury a-nd without loss of substance. 



INDICATIONS. — Incision is the preliminary step of 

 most all surgical operations, and when not constituting a 

 complete operation in itself, it is invariably necessary to un- 

 cover and render accessible the underlying structures which 

 require surgical interference. It is invariably the prelimi- 

 nary step of ablations, dissections, and resections. Growths, 

 organs, or parts of organs to be ablated or resected must 

 be first exposed by incisions through the skin and other in- 

 teguments which cover them. Surgical operations in which 

 incision is the principal feature are usually designated with 

 the suffix "otomy" after the name of the. structure incised: — 

 thus, incision of the skin is dermatotomy, of a tendon, tenot- 

 omy, of a muscle, myotomy, of a nerve, neurotomy, of the 

 scrotum, oscheotomy, of a bowel, enterotomy, of the abdomi- 

 nal cavity, celiotomy, of the flank, laparotomy, etc., etc. The 

 greajt number of this type of surgical operations indicates at 

 once the importance of incision as a surgical process; it enters 

 into every procedure in which a knife is used. 



INSTRUMENTS. — Incisions are made with various cut- 

 ting instruments according to the character of the struc- 

 ture to be incised. The scalpel, with a convex edge (Fig. 3) 



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