336 VETERINARY SURGICAL OPERATIONS 



the whole pectoral region is the seat of an enormous enlarge ■ 

 ment that interferes with locomotion. 



Delayed cicatrization of punctured wounds entering the 

 anterior surface of the chest (see page 491) due to the so- 

 journ of desiccated pus, sloughs or sequestra from the ster- 

 num, is another matter, and does not belong to the same or- 

 der of morbidities as the lesion we aim to describe under 

 this head. The real pectoral fistula is located inferiorly, has 

 its origin inferiorly and discharges inferiorly, and is no more 

 nor less than an inflammation of the sternum. The external 

 manifestations harmonize with the amount of the bone in- 

 volved. The lesion may be small when onlya circumscribed 

 spot of the bone is affected, or it may be enormous, indicat- 

 ing a general involvement of the wholej-bone and the car- 

 tilages attached to it. If not botryonftycotic, it certainly 

 seems to be due to some other specific cause. 



TECHNIQUE. — The patient must be cast or secured 

 upon the operating table with the uppermost leg drawn up- 

 ward. If cast there must be no ropes or straps crossing the 

 breast. 



An incision is made in the median line along the whole 

 length of the enlargement, which in some cases is more 

 than a foot long. The incision is carried fearlessly downward 

 until the knife meets resistance from the sternum. Then, in 

 order to give a better exposure of the bone, a few slices of the 

 fibrous walls are extirpated near the bottom of the wound, 

 on both sides, but it is not prudent to transgress too far 

 from the median line on account of the danger of dividing 

 large vessels. Attempts are made to trace the tracts into the 

 bone, and to submit them to a thorough curettage. If a tract 

 leads into a cavity, it is enlarged by chiseling' to give good 

 drainage and to remove any sequestra it might contain. 

 Other tracts into the bofje are searched for, and if found sub- 

 mitted to the same treatment. The tracts in the fibrous mass 

 are curetted and made to communicate directly with the 

 surgical wound. All- of the tracts in the fibrous mass, and the 

 cavities in the bone, are irrigated with a strong solution c s . 

 copper sulphate and then seared thoroughly with hot irons 

 until all of the bleeding is controlled. The searing not only 

 destroys much of the growth, but retards cicatrization of the 

 wound until the bone itself is ready to be reclothed with soft 

 f'ssues. 



AFTER-CARE. — In the standing position little can be 

 done to the wound except irrigating it with antiseptic water. 

 In the hospital the patient should be secured upon the table 



