222 VETERINARY SURGICAL OPERATIONS 



which is now divided by a second upward stroke of the 

 scalpel. This fascia is adherent to its subjacent structures 

 and cannot be separated as easily as the skin. It is, how- 

 ever, advisable to push it apart in both directions so as "to. 

 expose the tendon better. The tendon is then searched for 

 by palpation with a blunt instrument, — the closed dissecting 

 forcep or the handle of the scalpel. The tendon will be found 

 to move under the pressure of a blunt instrument, and is 

 thus accurately located and outlined. Its very edges can be 

 thus found. All of the surrounding structures are immov- 

 able and are easily differentiated from the tendon itself. 



Fifth Step.— Elevating and Resecting the Tendon.— The 

 inferior edge of the tendon is sought and slightly dissected 

 free from its attachments, so as to give a point of entrance 

 for the elevator. The best elevator is the curved scissors, 

 which are now passed under the tendon from below up- 

 wards until they are safely lodged and held by the pres- 

 sure. The probe-pointed bistoury is then passed under the 

 tendon in front of the scissors. The scissors are lifted up 

 so as to bring out as much tendon as possible as the bistoury 

 divides it. This leaves the distal stump protruding from the 

 incision, while the proximal stump sinks out of view by the 

 contraction of the muscle,. The distal stump is now grasped 

 with the dissecting forcep and as much of it as possible is 

 resected with the scalpel. 



Sixth Step. — Suturing the Incision. — The wound is 

 closed with interrupted sutures, with the exception of a 

 small orifice interiorly for drainage. The edges are care- 

 fully approximated and all of the haemorrhage should have 

 been previously arrested. 



Seventh Step. — Applying a Protective Dressing.— It is 

 important to guard the wound against infection from without 

 by applying an impervious coating of collodion over the su- 

 tured portion. A thick layer or two should be smeared over 

 the entire field with the exception of the drainage orifice 

 at the inferior commissure of the incision. 



AFTER-CARE.— The subject is kept in the standing, 

 position for five or six days, largely'for the purpose of keep- 

 ing the wound intact and to prevent its contamination with 

 the dirty floor or litter. On the sixth or seventh day the pro- 

 tective dressing is dissolved with ether and the stitches re- 

 moved. If the union of the edges is firm little additional 

 treatment will be required, besides that of keeping the parts 

 clean with weak antiseptic or astringent lotions. If the 

 union is not perfect, as is often the case, the wound must be 



