236 Veterinary surgical operations 



sue. The proper .management of secondary haemorrhage 

 consists of suturing the puncture with a pin held in place 

 with a figure eight. suture. The reapplication of a bandage 

 should be avoided ; it is a dangerous practice. Suturing is 

 by far the safest practice, although sometimes the blood may 

 find its way into the peri-rectal space, and if infection ensues 

 as a subsequent complication serious results may supervene. 

 It is when the middle coccygeal artery has been accidentally 

 severed that this sequel is most likely to occur. 



(3) Gangrene of the tail ensues when there has been a 

 too radical interference with the caudal circulation, either 

 from having cut too many of its nutrient arteries, from pro- 

 longed bandage compression, or from the improper use of 

 the pulleys and weights, and especially when these faults are 

 added to unclean methods of operating or unclean after-care. 

 Microbes find a mighty favorable field in the partially strang- 

 ulated tail, or before collateral circulation has been suf- 

 ficiently established. The prevention consists of (1) avoid- 

 ing the severing of the middle coccygeal artery, (2) avoid- 

 ing the use of too heavy weights, (3) placing the weights so 

 as to pull backward rather than forward, (4) removing the 

 bandage in two to three hours and then never re-applying it 

 to control secondary haemorrhage, and (5) operating under 

 strict aseptic conditions. 



The treatment of threatened gangrene consists of free 

 evacuation of accumulated secretions and the application of 

 hot antiseptic baths. When well established, amputation of 

 the dead portion should not be delayed. 



(3) Wound Infection. — The infection of the wound of 

 caudal myotomy varies in seriousness from a trivial infective 

 inflammation ending in harmless suppuration, to grave and 

 even fatal septicaemia. The blood clot within Ihe wound may 

 also extend into the peri-rectal space, and if it becomes the 

 seat of an active microbian growth, especially when the in- 

 tegrity of the caudal circulation has been seriously impaired, 

 threatening local and general symptoms may follow. Fatal 

 septicaemia, tetanus, and malignant cedema have been occa- 

 sionally noticed as sequelae of improperly executed caudal 

 .myotomies. The prevention is found in the use of a per- 

 fectly sterilized tenetome and thorough cleansing of the seat 

 of puncture. With these precautions fully respected the 

 wound will he'al without perceptible reaction, even when 

 other errors in management are' made. When sepsis is no- 

 ticed the treatment must begin at once. The wound is 

 opened, and pus squeezed out and hydrogen peroxide in 



