136 VETERINARY SURGICAL OPERATIONS 



small pledget of cotton. With these precautions the plantar 

 operations can be nicely executed without much ceremony. 

 Here and there, however, a patient is encountered that will 

 defeat the operator and will need to be placed under more 

 adequate restraint. 



THE TECHNIQUE OF NEUROTOMY.— Neurotomy 

 is a simple operation. It is performed upon strictly healthy 

 tissues; the tissues are only incised, divided; there is no ne- 

 cessity for mutilation; there is no drainage required; the skin 

 is thick and well nourished at the various points of operation. 

 In fact everything is favorable for prompt, healing of the 

 wound, providing the technique is made to conform to the 

 ordinary rules of clean surgery. The field of operation re- 

 quires thorough cleansing with antiseptics after having been 

 shaved; the instruments are sterilized; the hands are kept 

 clean and digital manipulations avoided; the sutures used for 

 closing the wound are always sterilized sutures removed 

 from the sealed glass containers only at the time of use ; the 

 blood is bailed from the wound with sterilized sponges or cot- 

 ton; and finally the wound is protected with appropriate 

 surgical dressing recommended for incised wounds requiring 

 no drainage. 



The Incision and Dissection. — The exact seat of the in- 

 cision is located and its length decided upon after a careful 

 and patient palpation and inspection of the region. Legs of 

 horses differ somewhat in their contour, in their conforma- 

 tion, and they may be abnormal from disease to the extent of 

 actually deceiving the casual operator unless the parts are 

 carefully surveyed. The aim should be to make the incision 

 exactly over the nerve trunk. When the location is decided 

 upon the skin is held tense with the left hand without dis- 

 turbing its normal relations, while the incision is carefully 

 carried through it with the right one. When the skin is cut 

 through throughout the whole length of the incision the dis- 

 section fqreep is taken in the left hand to be used as a re- 

 tractor of one of the edges of the skin. At this stage some 

 operators have recommended the use of various retractors 

 to dilate the incision. The forcep retractor and the elastic 

 retractor (Fig. 90) are chiefly mentioned in this connec- 

 tion. These expedients are necessary only in the deep 

 neurotomies (median tibial, peroneal, etc.) In the plantar 

 operations the dissection forcep is quite sufficient to open up 

 the wound to facilitate the division of the subjacent tissues, 

 unless some unexpected situation arises. 



The technique that usually gives the best satisfaction and 



